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#16 – Dismiss Clients

It’s not the hot towel that counts. It’s how it’s delivered.

If the doctor and his chairside assistant are running behind, you may be asked to help the client when treatment is completed. Greet the client by name with a smile. Bring the chair to an upright position. Allow the client to sit upright for 1- 2 minutes to reestablish his/her equilibrium. Ask them if they would like to rinse. Make sure their folder is filled out:
a. Treatment and fee written in
b. Next appointment (if needed) on treatment sheet (Dr. can tell you what and how much time needed)

Make sure their face is clean, hair neat, and glasses clean. Offer a hot towel if the client has had any trauma (injection, long appointment, etc.) offer three 200-mg. ibuprofen (Advil or Nuprin). Sit down so you’re close to eye level with your client. The client will be ready to leave, but it’s valuable to spend one minute to view the treatment performed. Say to the client “Today Dr. __________ did…” This is a chance to outline briefly the treatment accomplished.

Now is the time to discuss what your client can expect over the next couple days sore gums, protect a filling, care with a temporary crown

Crown or bridge
a. Sore gums Listerine, Periogard, brush and floss (never pop out of the contact, this could loosen the crown)
b. Sensitivity to cold decrease with time
c. Tooth sore give 2 Ibuprofen (can take 2 at 4-hour intervals)
d. Temporary crowns avoid sticky foods, use denture adhesive or call us if comes loose use toothpaste to hold crown in place in the meantime
e. While numb be careful not to bite tongue or lip
f. Final seating praise the treatment. Show the client
Amalgam
a. Sore gums brush and floss
b. Sensitivity to cold often for 1 2 weeks, then usually goes away
c. Chew on other side today
d. While numb be careful not to bite tongue or lip
e. Great to be done
Plastic
a. Sore gums brush and floss
b. Sensitivity to cold often for 1 2 weeks then usually goes away
c. Completely hard can chew on it immediately
d. While numb be careful not to bite tongue or lip
e. Show the client. Praise appearance

Complete partial denture, TMJ’s splint
a. Call if any sore spots or other problems
b. They have priority and will be seen within 2 hours
c. Wear appliance when come in so problem will be apparent
d. Praise the appearance! Show the client.

Next, discuss what will happen at their next appointment. You will find this information either in the yellow treatment sheet, remarks box, or on the client’s salmon sheet. Tell your client what will be done at the next appointment and about how long the appointment will be. Make sure you answer any questions.
Finally, ask “Was there any way we could have served you better?”

When all questions are answered, stand up and remove the client’s bib. This is the signal that the appointment is over. This is an important few minutes. Don’t hurry the client. No client should ever walk to the front desk alone.
Back staff person walks client and chart to the front side of the desk at the same time.
Front staff person notices
Front staff person excuses herself from current client/phone call.
Front staff person asks, “_______(back staff person) do you need some assistance?”
If front staff person does not notice, back staff person says, “Excuse me, ________ (front staff person), may I interrupt you for a minute?”

Back staff person has treatment sheet and is ready for hand-off.
Back staff person says, “_________ (staff person) this is “Joe” and he needs to come back in _______(amount of time) for ___________. I noted everything on the treatment sheet.” OR “______(staff person) this is “Joe” and he doesn’t need to come back until ________(next recall date). ____(staff person) will be with you as soon as possible Joe.”

If they have received a new crown or denture, be sure to compliment them on its appearance. Be sincere! If their treatment is completed mention how happy you are that they are healthy again.

Try to find a positive upbeat way to finish your conversation. Return to the operatory. Put your gloves on. Clean just as you would to start a day. Biocide all flat surfaces. Remove and rewrap all Saran wrap. Place burs in baby jar with Glutaraldehyde. After the room is cleaned, take the tray to lab/sterilization area. Throw away all the used disposable supplies. Don’t recap, bend, or break needles after use. Carefully remove needle from syringe and place in container in the treatment room. You can use the cotton forceps to help hold the needle hub and make it easier to unscrew the needle.
Any material soaked with blood, extracted teeth, surgically excised gum tissue and used sharps should be treated as infected medical waste.
1. Sharps into sharp container (includes anesthetic carpules and matrix bands)
2. Blood soaked dripping gauze etc. in a plastic bag marked with biohazard symbol – If gauze only has some blood on it, it can be disposed of normally.
3. Liquid collected in high velocity evacuation system can be poured down the drain
4. Amalgam scraps

Also remove the air/water syringe tips. These will be cold sterilized. Clean the nitrous oxide inhaler with Glutaraldehyde, and then wipe off with plain water. If you have time, clean/sterilize the instruments. If you don’t have time, place them in the cold sterilizer to keep debris from hardening on the instruments. Check the floor for burs or instruments that may have fallen. Remove your gloves. Wash your hands. Run the high speed with water to flush the line for 30 seconds. Prepare for the next client.

Signed off by _____________________

Date _____________________