Tough times come and go, and one of the challenges is we never know exactly when they will strike. It could be a national emergency like COVID-19, a tragedy in your town, or even a personal setback.
In any case, these kinds of events can exacerbate what is already one of the biggest challenges in the dental profession: burnout.
Dentists, hygienists and other dental professionals report a very high incidence of stress and burnout, with concerns ranging from litigation to regulation to maintaining high standards of patient care.
What does burnout look like, and how can you avoid it in these difficult times? Below, we’ll help you recognize the warning signs and outline ways to build your resilience – whether times are good, bad, or somewhere in between!
What is ‘Burnout’ in the Dental Profession?
Burnout is a state of overall exhaustion that affects your mind, emotions, and body, caused by exposure to prolonged and excessive stress.
When you’re going through a personal struggle or affected by an event like COVID-19, there will always be times of greater stress in your life. Add that to the day-to-day challenges of managing your business and career… it’s easy to see how these forces combine into a recipe for burnout.
Burnout can stem from anything in your life that causes long-term stress. Living through a long, stressful period in your practice, whether your business is struggling to survive or overloaded with patients, is a common cause. Even if you don’t own the clinic directly, the strain from these types of situations can get to you – in fact, dental assistants show higher burnout scores in studies than other staff.
What Burnout Looks Like
Burnout makes every day feel like a bad day. It often feels like you have lost your passion for everything, and work that used to excite and challenge you suddenly seems dull and pointless. You may feel like nothing you do makes a difference, even when it does.
The main difference between ordinary stress and burnout is that burnout is a chronic condition. While stress is temporary, burnout is constant. When you’re experiencing stress, cynicism, exhaustion and frustration day in and day out, you could be experiencing dental burnout.
Everyone reacts differently to prolonged stress, so burnout won’t look the same in each person. It’s important not to discount your burnout simply because it looks different than someone else’s.
Physical illness, including headaches or digestive issues
Feeling exhausted no matter how much you sleep
Overall disengagement with work and your personal life
Once you’ve hit burnout, you may need professional help to recover. Don’t be shy about looking for a therapist, counsellor, psychiatrist or another mental health professional to help you get back on your feet.
How to Be Resilient and Avoid Burnout
The key to avoiding dental burnout is to prioritize your own needs. That can be very hard for dentists and hygienists, who feel they have such a strong obligation to others’ needs.
Because dentistry is a caregiving profession, it’s easy to get so focused on taking care of your patients and others in your life that you forget to nurture yourself. This is especially true if you spend a lot of time with patients, hearing their stories and sharing in their challenges.
However, you can’t give back when you’re pushed up against the wall. Taking care of yourself is how you maintain your ability to care for others.
Chances are you’re familiar with the notion of “self-care”, but many people are mistaken thinking it’s all about pampering yourself. Self-care goes far deeper than that. Pampering is great, but you need to take other steps as well!
Here are some ways to care for yourself:
Calm your mind with meditation or other mindfulness practices
Eat healthy meals that provide you with the energy you need
If you’ve been going back and forth on amalgam and whether you should continue using it in your practice, the findings of a new study could provide some clarity.
For two full years, five undergraduate students at Loma Linda University examined the impact of extreme contaminations on amalgam fillings during condensation. The goal of these dedicated research design students was to determine the shear-strength degradation effects on dental amalgam.
The researchers assessed the reaction of amalgam to gross contamination during condensation under the following elements:
Handpiece lubrication oil
The results, published under the title, “Amalgam Strength Resistance to Various Contaminants,” demonstrated that amalgam is capable of withstanding “worst-case-scenario” levels of contamination equally or better than its alternatives, including resin-modified glass ionomer.
Just How Well Does Amalgam Retain Its Strength?
To summarize, here’s a breakdown of the findings discovered in the research discussed above:
Amalgam strength wasn’t reduced to a significantly statistical extent (p= 0.05) by water contamination.
Compared to water and blood-contaminated water, saliva reduced in between both.
In saliva, the final remaining strength was the same or more than the uncontaminated strengths recorded in the available literature for other restorable materials (e.g., composite resin, resin-modified glass ionomer, glass ionomer.)
Amalgam strength degradation was at its most significant – at around 50% – when fully immersed in handpiece lubrication oil during condensation. However, contamination from handpiece lubrication oil was proven to be highly unlikely in practice.
Still, the oil contamination resulted in amalgam strengths were the same or more than other available restorative materials while exceeding the minimum compressive strength of 35,000 pounds per square inch
How Do the Alternatives Compare to Dental Amalgam?
The results above already indicate the dental amalgam can withstand contaminative circumstances better than many alternatives.
Let’s look closer at the alternatives and see how they stack up.
1. Composite Resin Fillings
As the most regularly used alternative to dental amalgam, composite resin fillings are tooth-coloured and white. Acrylic resin is the primary material used in the making of these fillings—and they’re reinforced with powdered glass filler.
It’s common for composite resin colours to be customized to match surrounding teeth. They’re also often light-cured by blue light in layers to lead into the last restoration.
Yes, there’s no doubting the strength and blending capabilities of these fillings. Also, they don’t need much removal of healthy tooth structure for placement.
But they come up short in other aspects.
First and foremost, the composite resin is harder to place than amalgam—plus, they’re infinitely more expensive. Lastly, while they are strong, these fillings appear to be less durable than amalgam.
2. Glass Ionomer Cement Fillings
Organic acids (such as eugenol), bases (such as zinc oxide), and potentially acrylic resins can be found in glass ionomer cement.
Glass ionomer fillings are tooth-coloured like composite resin, and its properties seem most ideal for more meagre restorations.
These fillings cure on their own and don’t necessitate a blue light for the setting process.
While ease of use and quality of appearances are definite plusses with glass ionomer cement, they’re not particularly useful for more significant restorations.
Is Amalgam Usage Long for this World?
Of course, we can’t forget that these findings are only part of a bigger picture on the use of dental amalgam.
The material’s mercury content makes dental amalgam a public health and ecological risk, particularly after its removal. On July 14, 2017, the Environmental Protection Agency (EPA) finalized regulation specifically targeting the use and disposal of dental amalgam. In Canada, dentists must use amalgam traps and filters to collect amalgam waste and recycle it appropriately.
As such, many dentists – as a protective measure – are opting to use alternatives to amalgam for health, safety and ecological reasons.
It’s a fact: millennials are now the single biggest generation in both Canada and the U.S. There are over 83.1 million American millennials and about 10 million to the north.
So, why aren’t you seeing more of them in your practice?
You’re not alone if you’ve had difficulty bringing this generation of potential patients on board. Sure, you’ll see them in for the occasional extraction or filling...but when it’s time for a regular cleaning, millennials aren’t inclined to call back.
It’s not that Gen Y doesn’t want or need dental care ‒ but they often require a different tact than you’d take to recruit and retain your usual patients.
Why Gen Y Isn’t Always An Easy Win
In a recent article for HygieneTown, RDH Katrina Sanders lays out a few of the things that make the millennial generation (people born between 1983 and 1997) different when it comes to their approach to dental care.
First, many millennials experienced divorce in their families growing up. Because of this, they tend to wait longer to marry and have children (if they do at all.)
Older millennials took on significant student loans and graduated at the height of the Great Recession, leading many to unstable career and financial situations. Many work part-time, multiple jobs or flexible hours.
Millennials also saw their parents and grandparents, many of whom committed decades of service to their employers, suffer job loss during the Recession.
What does this all mean for you as a dental professional? Well, as Sanders explains, these tendencies affect Gen Y’s attitude about going to the dentist. Understanding these traits can go a long way in helping you attract more millennial patients and keep them coming back after the initial treatment!
1. Involve Millennials in Their Dental Care
Back in university or hygiene school, you might’ve learned to look at a patient’s involvement in their healthcare through scales like the Health Belief Model or Dental IQ.
But millennials don’t always fit the book.
Although they are often highly educated and concerned about their health, millennials are also notorious for scrutinizing the ins and outs of anything they spend their money on. They need to truly believe in what they’re ‘buying’, even when it comes to oral healthcare.
Unfortunately, many millennials simply don’t consider regular dental checkups or teeth cleanings worth missing a day of work. Taking time off is tricky when you’ve got multiple employers and family obligations packed into one schedule.
Any practice that can offer weekend or evening appointments has a huge advantage when it comes to winning over this generation of patients.
4. Offer Financing Options
For better or worse, millennials are willing to shop around for a dentist, especially when they’re on a tight budget. As Sanders illustrates in her HygieneTown piece, most
millennials will respond to a proposed dental treatment in one of three ways:
Agree to have the treatment, but request several monthly payments broken up over an extended period.
Look for another dentist that can provide the same treatment at a discount.
Ask you to dull the pain, but not cure the problem.
Fact is, fewer millennials have insurance coverage than previous generations, and we know that those without insurance are more likely to avoid getting proper dental care due to cost. But if you can offer an alternative to paying out-of-pocket, it will win over millennials who are likely to become long-term patients and a great referral source.
5. Keep In Touch
But it’s not always an aversion to phone calls or dental bills that keeps millennials out of the chair.
Between a growing career, a young family and a world of constant distraction, sometimes dental care just falls off the radar.
This is where it helps to reach out to patients outside office hours. To start, following up after the appointment by text or email is an incredibly simple way to make a connection and remind them you care. You can continue fostering that connection via social media, sharing blogs, videos and resources.
Remember: millennials aren’t your enemy! They have all the same needs as your other patients, and they’re a valuable source of business ‒ especially as the older ones are settling down and starting families. A bit of flexibility on your part can go a long way in winning them over as dental patients.
In any business, there are customers that we like and customers that test our patience. The same goes for the patients that visit the dentist’s office.
And sometimes, it’s hard to handle them so that they have the best experience and you can do your job.
Here are 4 types of patients that can be difficult and how to manage them.
1. The Google Expert
We all know that one patient.
They know all the latest and greatest medical news and can’t wait to share with the dental hygienist. Instead of giving them a cleaning, we’re bombarded with questions that have taken four years of dentistry school to learn.
“Why didn’t you use this treatment?’
“Shouldn’t you be doing this?”
It can be exhausting.
It’s wonderful that the patient is enthusiastic about getting involved with the process, but it can hinder dental hygienists’ trying to do their job and sometimes even be harmful to the patient.
It’s 3:50. Their appointment was at 3:30. At this point, we’re assuming they just aren’t coming.
That’s when they stroll on in. The only thing more frustrating than that is if it happens on the regular.
Lateness has a domino effect. Regardless if all the next patients are on time, there’s no way to get back that 20 minutes. The worst part is making other patients wait just because someone has chronic tardiness. It isn’t good for anyone.
The best way to manage lateness is to incorporate a late policy. And stick to it.
Anyone that is more than 15-20 minutes late to their appointment, cannot be seen that day and will have to reschedule.
Generally, patients will respect the set appointment time and it will reduce the amount of late arrivers.
As dental hygienists, no one wants to see a patient cringe and tense as we recline the chair or pull back their cheeks. But no matter what we try to do to calm them, nothing works.
Sometimes, their discomfort and tension can radiate onto us, making us nervous too.
The best advice is to stay calm yourself. This is much easier said than done but often times what you put out into the world you get back in return.
It may be beneficial to open up the floor to a discussion about what is causing the anxiety and how we, as hygienists, can ease that discomfort. By knowing what makes them the most worried, you can avoid or minimize that factor.
In extreme cases, the patient may need to consult their doctor for anti-anxiety medication to take before appointments.
4. The Chatty Cathy
You love them, but at the same time they can be quite frustrating.
These are the types that will get to know you, ask about the kids or about upcoming vacations. They are often the sweetest patients you’ll get!
As much as they make the workday go by faster, they can eat into the appointment through their conversations and suddenly we’re behind schedule!
It can be challenging when managing a Chatty Cathy because we don’t want to be rude in any way but we also have to get the job done on time. But like any skill, managing chatty patients comes with time and experience.
Focus the conversations towards the beginning and end of the appointment as well as during the period of time before the patient is seen by the doctor. These time zones are optimal for conversations because they don’t interrupt your job but also give the patient a chance to socialize.
Not only that but it will also build a better relationship with the patient!
While these four types of difficult patients can pose a challenge, there’s nothing we, as dental hygienists, can’t handle.
The dental community is made up of healthcare professionals that care about the environment and with that goal in mind, dental office waste management has become an important aspect of the modern dental practice.
The waste that dental offices generate while delivering dental care includes a variety of materials that present a potential challenge to the environment. Dental practitioners are responsible for proper disposal methods of these materials to ensure both the public’s safety and minimize their effect on the environment.
Examples of such waste items include:
Dental amalgam containing mercury,
Biomedical office waste including spent x-ray processing solutions, disinfectants, cotton, plastic, latex, and glass which may be contaminated with bodily fluids and sharps including lancets, needles, and syringes, and
General office waste.
Dental amalgam is a safe, durable, long-lasting, cost-effective material that has been used as a filling material for more than 150 years. Amalgam contains mercury, which is a toxic and bioaccumlative material, continuing to accumulate in living organisms, thereby posing a threat to plants, animals and humans should it enter the water system. Left uncontained, mercury has the potential to enter our food web, harming birds and fish.
Amalgam that is replaced or removed generates mercury-containing waste when amalgam particles are vacuumed from the mouth. These particles must be effectively collected and maintained. To this end, many dental practitioners have chair-side filtration devices that collect larger particles of dental amalgam removed via suction. Amalgam separators are devices designed to filter finer amalgam particles from the wastewater to reduce the amount of amalgam entering the sewage system.
There are standards and regulations in place in Ontario associated with the quality of the dental practice and amalgam waste disposal. The Royal College of Dental Surgeons of Ontario establishes and maintains a standard of practice under the regulated Health Professions Act, 1991, and the Dentistry Act, 1991.
Silver is another heavy metal that can be found in dental amalgam. It also occurs as silver thiosulfate in radiographic fixer, a solution used in the processing of dental radiographs (x-rays). The used fixer must not be washed down the drain. Dentists can install in-house recovery units that recover the silver for reuse.
Another common waste product from the dental office is unused film, since they contain unreacted silver that can be toxic in the environment.
Incorporating digital imaging as a replacement means to obtain dental radiographs reduces the amount of silver waste generated by the dental office.
Lead shields that are contained in each film packet used in traditional radiography are another waste product of the dental industry. Lead, like mercury and silver, is toxic to the environment and accumulates in the environment. These lead packets need to be collected and returned periodically to the supplier for recycling.
Biomedical Office Waste
Biomedical waste is one of the many types of waste regulated by the Ministry of the Environment and Climate Change. Biomedical waste includes any materials capable of causing disease such as blood-soaked gauze, tissues, and syringes.
General Office Waste
Dental offices can also minimize the effect of waste accumulation in the environment by implementing best practices such as:
Purchasing products with minimal packaging
Use of reusable plastic containers
Use of products made from recycled or partly recycled materials
Use of energy-efficient office lighting
Conscientious use of paper in the dental office for printing and use of both sides of a sheet of paper
By implementing best practices in the collection and disposal of dental office waste, a dental office can successfully minimize and substantially reduce the effects of dental waste on the environment.
There are many corporate-style dental practices cropping up, and plenty of advantages to being part of a large-scale dental service. But despite many smaller practices being scooped up, you can rest assured that privately practicing dentists aren’t going anywhere!
There is a lot to gain by remaining small! The freedoms that come with your own practice can benefit staff and dental patients alike.
1. Customer Service and Individualized Patient Care
Private dental practice has roots in the community. The smaller the practice, the more opportunities to create and maintain meaningful relationships with your dental patients. These connections are priceless and a huge advantage over corporate chatbots and AI customer service interaction.
While a corporation may push for quotas, introductory offers, and discounts ruled by their budgets, often at the patient’s expense—a privately practicing dentist will always be looking out for their patients’ best interests.
2. Human Resources
Having a solid, experienced team you can trust is key to delivering quality dental care. You have to rely on your team and be able to collaborate well in order to be successful.
As a practicing dentist running your own clinic, you have the ability to make any personnel changes you feel are necessary. It’ll be your responsibility to hire whomever you want to get a good group of team members that click together. You’ll have the freedom to implement your own policies, health benefits, bonus structure, and training programs.
Nothing is more frustrating than having management make decisions that ultimately affect your patient’s care. As an employee of a large corporation, you would need to abide by the company’s rules, whether that means replacing your personal assistant or backing one brand of supplier exclusively over another.
However, the freedoms of owning a private dental practice do come at a price. There is all the hiring and firing, scheduling, insurance filing, accounts receivable, and other management decisions that go into running a business. To accomplish these tasks, you can hire an office manager that you feel is the most knowledgeable and who’s thinking is in line with your own.
Being the master of your own marketing campaign offers huge rewards. You may be up against some large established dental corporations that have huge marketing machines, but you also have the freedom to share your own unique story. As a private practitioner, you can choose how to market yourself and stand out from the crowd.
5. Third-Party Vendors
The quality of dentistry you can provide is not always determined by skill alone. Dentistry skills rely on hardware, software, and a variety of consumables used to deliver high-quality dental care.
Running your own practice allows you to choose your own vendors by price and quality of service. It allows you to try out new cutting-edge techniques, equipment, and strategies. Additionally, you would not be constrained to a specific theory of dentistry and limited to only the techniques and treatment plans that the practice selects.
6. Your Goals as Privately Practicing Dentist
You’ve worked and studied hard to become a dentist. Becoming a cog in a large corporate dentistry wheel may not be your idea of success in your field. Starting your day with morning meetings reviewing financial metrics over delivering quality individualized dental care may not be in line with your goals.
As a privately practicing dentist, your focus is on making sure each patient receives the individualized care that they need, from taking the time to discuss brushing techniques to an after-hours dental emergency.
Standards are crucial to maintain the quality of the dental office and the dental profession. They help gain and maintain trust of the patients.
Do you know if your office is up to code?
Here are 7 questions to consider, ensuring your hygiene department is up to the current standards.
1. Are you viewed as “just a cleaning”?
Patients that tend to postpone regular checkups lack the preventative care that dentists can provide. Without regular cleanings, patients return months later with cavities, gum disease and pain.
The expense of dental cleanings is an important one to make. Cleanings every 6 months may seem like a lot (especially without insurance) but they are necessary. It prevents more expensive and invasive treatments once a disease takes hold.
An example of this is the progression of gingivitis to periodontitis. Gingivitis is easily treatable if identified early on by a hygienist. However, if it is left untreated can lead to irreversible periodontitis.
Periodontitis can lead to:
Decreased nutritional intake
Serious disease within your body
During regular appointments dental hygienists identify any areas of potential disease, provide thorough cleanings and advise for at-home care and techniques.
2. Do all your practitioners understand oral health affects overall wellness?
Proper care to your body, like nutrition, is equally important for patients oral health.
This is because your body is full of bacteria, typically the bacteria is harmless. Your natural defenses and good oral health can keep these bacteria under control.
Without that care is when bacteria can get out of control. This can lead to oral infections such as tooth decay and gum disease.
Studies can show that there are connections to internal diseases and oral hygiene. Known internal diseases include:
Endocarditis – This typically occurs when bacteria or other germs from other places in your body, such as the mouth develops. That bacteria then spreads through the bloodstream and into damaged areas of the heart.
Cardiovascular disease – heart disease, clogged arteries and strokes could be linked to inflammations and infections caused by oral bacteria.
Pregnancy and birth – Premature birth and low birth weight and periodontitis has been found to be correlated.
3. Are all oral evaluations with measurements comprehensively documented?
Whenever a dental practice is performed, it should be documented.
There are guidelines specifically designed to help practitioners meet the legal requirements for dental record keeping.
The following are basic record keeping information from the official RCDSO:
Accurate general patient information
A medical and dental history that is periodically updated
Accurate description of the conditions that are present on initial examinations (this includes entries such as “within normal limits” where appropriate)
Record of significant findings of all supporting diagnostic aids, tests and referrals like radiographs, study models, and reports
Diagnosis and treatment plan
Notation that informed consent was obtained from the patient
Description of all treatment that is provided, materials and drugs used and, if appropriate, the outcome of treatment
Accurate financial records
4. Do adult patients receive periodontal exams annually?
Comprehensive periodontal evaluations (CPE) are ways to assess patient’s periodontal health. It examines teeth, plaque, gums, bite, bone structure and any risk factors.
With yearly oral health assessments, both patients and dental professionals will know how healthy the patient’s mouth is. They will be able to notice any conditions like periodontal disease that have developed and in need of treatment.
5. Are there clear diagnostic distinctions between health, disease and maintenance oral health status?
If a patient has an active disease, is the hygiene department clear on case types of early, moderate and advanced conditions?
Everyone’s definition of something may be different.
As practitioners, we must make a point to make sure everyone on the team is on the same page. This will allow the documentation clearer to everyone and other members can easily pick up where it was left off.
6. Is there proper communication with the patients?
There are several important questions that will help initiate and maintain good communications with patients.
Is the hygiene team communicating with every patient the status of their supporting structures of bone and gums that hold their teeth in place?
What patient education tools, technology and visuals are being used to make sure the patient understands their status?
Do patients understand why they need the periodontal care and frequency regardless of how many sessions they have covered or what insurance pays?
Does the practice perform root planning, scaling and home care guidelines for patients with active disease?
Are patients with disease returning for their revaluation to assess their healing and success of gum therapy?
Proper communications are key for patients to understand what is happening to them.
Not only should people be spoken to with a professional attitude in person but also on the phone or through email. Whenever dealing directly with customers, confidence and professionalism is key to make a successful impression.
Here are 6 mannerisms to consider when projecting your ideal front desk first impression.
1. Open with a Friendly Greeting and Nice Smile
A simple “Good morning, what can I help you with today?” could help build the beginning of a good relationship with your customer. This swiftly puts the needs of the customer before the needs of yourself, making them feel important.
One of the most important things that anyone providing customer service can do to dramatically improve your interactions is smiling. Not only does it convey to the customer that you are happy to assist them, but it improves your own mood too.
Happiness spawns happiness. Even customers having a bad day will likely be more pleasant if you continuously reply with a friendly tone.
2. Eye Contact
It may sound cliché, but it’s important to maintain strong eye contact throughout your interactions.
Eye contact indicates to the customer that you are present, listening and focused on them. It helps build a connection with them. They feel valued as a result.
By not engaging in eye contact, the customer could assume you do not want to help them, or that you are unsure about their inquiry. This could cause the customer to feel a negative association with you and the company you work for.
Not only that but eye contact is a huge trust builder. Especially with medical practitioners, gaining trust is crucial in order for the customer to be comfortable. Eye contact ensures that, as a receptionist, you know what you are talking about and thus your organization also does. Safety and security are the keys to building happy relationships with your customers.
3. Pay Attention to the Customer
Never ignore the customer. They are your number one priority. Show to the customer that they have your full, willing and undivided attention throughout the entire interaction.
You can demonstrate this by simply asking for their name and using it throughout the conversation. You will not only make the customer feel like they have your full attention, but people will feel a significantly increased rapport by making the interaction personal to them.
4. Speak Slowly
This might be considered odd but could help you improve information being presented for those that may get nervous or just generally speak quickly.
Stumbling or pausing is natural for people to do but it can come across as unprofessional. When speaking quickly, it can hinder the comprehension of information for your visitors. Your information should be clearly presented and speaking slowly limits the amount of opportunities for you to stumble or pause awkwardly.
By minimizing the faults in your speech, you project a very strong sense of knowledge and charisma. You become more enjoyable to listen to as a result.
5. Personal Presentation
How you appear when working is how you are representing your business. Customers will identify the products and your business as respectable because you show respect towards them.
Depending on your establishment, you may have a uniform, or you may be free to choose your own attire. In the case of the latter, you should tailor the wardrobe to the company standards.
When dealing with documents or products, something that is overlooked is keeping nails well-groomed and professional. Your desk should reflect this as well. A messy desk can make the company feel disorganized and sloppy.
Outward appearance is not all of your personal presentation though. How you present your outward appearance affects you too. Confidence is often conveyed through posture. Straight but still relaxed posture exemplifies natural confidence and a pleasant appearance.
Fidgeting and/or constant movement adjustments can distract the customer and make you appear unsure of yourself. Minimizing this can help you seem more engaged or present in the conversation.
Customers will always favour doing business with someone who is pleasant and happy.
Your attitude is a reflection on the respect you have towards the establishment. Similarly, it affects how you approach your job and the people you interact with. A negative attitude pushes the customer away.
It’s important to maintain a positive atmosphere, even when feeling subpar, because people often copy others’ emotions. What you convey to the customer is what you will most likely receive.
There are always ways for you to improve the impression you present to customers. This should shed some light on some areas maybe that have been neglected or introduced you to new ideas.
October has come and gone, and cannabis is officially legal in Canada. What does this mean for your dental practice and your employees?
It means that there is going to be some change within your office, and you will have to take a few steps to keep a happy, well-informed team.
Your main priority is to gain an understanding of the regulations for medical and non-medical use, as well as the expectations of your staff. This knowledge is essential in establishing a clear, permissible policy on cannabis in your practice.
What’s the Policy on Cannabis in Your Dental Practice?
Take time to have a look at the current policies and practices in place. Do your employees understand their rights concerning cannabis use?
If you don’t have a clearly-outlined process in place, this is a great time to create a new one, adding in the new cannabis policies.
When Can Your Employees Use Cannabis?
Does the legalization of cannabis mean employees can use it at work?
In some cases, the answer is yes.
There is a “duty to accommodate” in Canada, which applies to those who are affected by a disability and require cannabis for a medical purpose. This allows prescription cannabis use in the workplace, but they must have medical notation.
That being said, your employees have a right to privacy. You may ask for a doctor’s notation, but it does not have to specify the impairment related to their medical cannabis use.
There is also a duty to accommodate those who are affected by cannabis smoke or vapour. You may have to establish a specific area of the office where employees can consume medical cannabis away from those who it negatively affects, or ask that users consume edible cannabis instead. Consider which approach will allow you to fulfill your duty while maintaining a positive, inclusive work environment.
Is Recreational Cannabis Use Legal in the Workplace?
Despite its legalization, it is not legal for employees to use recreational cannabis within the walls of your dental practice. Laws against smoking in the workplace still apply.
Additionally, the legalization of cannabis does not give people the right to be impaired on the job. This includes using cannabis before work if the effects will cause impairment during work hours.
According to workplace medical testing and assessments company DriverCheck, cannabis impairment can last for 24 hours. This is important to communicate to your employees, especially those who may use cannabis recreationally on the weekend, to ensure sobriety for Monday morning.
How to Discuss a Cannabis Policy with Your Employees
Communicating your policy to your staff is key. This is a new law, and everyone is still learning about it, so it’s important to be on the same page.
For medical cannabis users, it’s important to create a safe and open environment for employees to approach you with their medical needs. This will allow open and honest communication around cannabis use and a smooth accommodation process.
For recreational use, be sure to communicate your expectations to your staff verbally and in writing. Some may think that marijuana use is like cigarette use on company time — it’s important to debunk this right away.
When everyone understands the new policies, your office can move forward with the new cannabis law in a professional manner for both you and your patients.
Cannabis Legalization and Your Dental Practice
Communication is key. Ensure your policies are clear and both medical and non-medical policies and expectations are outlined. This will ensure a positive work environment surrounding cannabis and will make for a clear understanding for you and your team moving forward.
When dentists place new amalgam fillings or remove old ones, water containing amalgam particles is flushed into chair-side drains. These mercury-containing particles then enter the wastewater disposal system and water treatment plants. From there, the amalgam particles may be incinerated, land-filled, or made into fertilizer pellets for lawns or gardens. In each case, mercury from amalgam fillings is discharged into the environment, where it may bioaccumulate in fish and contaminate the food chain.
To summarize, dental offices that work with amalgam fillings (including “mercury-free” practices that only remove them) flush amalgam particles containing mercury down the drain and into the wastewater system. These particles ultimately become environmental pollutants.
The regulation applies to most dental practices that discharge waste into a public sewer or wastewater system. The basic requirements are:
Using amalgam separators (or equivalent devices) to remove dental amalgam solids from all amalgam process wastewater;
Implementing best management practices;
Complying with reporting requirements; and
Maintaining certain records documenting compliance.
Practices have until July 2020 to comply.
What Are Amalgam Separators?
An amalgam separator is a device installed on a dental vacuum line to filter out mercury and other particles from water waste before they enter the sewer system. The captured mercury can then be recycled to industry or safely disposed of.
Traditionally, dental practices used chair-side traps and vacuum filters to capture amalgam waste; however, the ADA estimates that 6.5 tons of mercury bypass these filters annually.
In addition to reducing environmental pollution, using an amalgam separator can help to extend the life of vacuum pumps by preventing solid particles from entering and damaging the pump.
To comply with EPA regulation, an amalgam separator must be ISO 11143:2008-certified to remove greater than 95% of solids by weight. Most amalgam separators on the North American market meet this standard.