	It’s the end of your workday and you are about ready to walk out the door. You would ideally like to look back on the day and feel 

, productive, and confident in your leadershipaccomplishments but you don’t. Instead, you are exhausted! 

Like so many leaders, you have just spent your day running on the proverbial hamster wheel. You have been busy, but haven’t accomplished much of what you wanted to do. Instead, you have dealt with numerous interruptions and conflicts, you have focused far too much time on projects that others could have handled, and have been irritable and short with people at times. You can’t wait to get home to relax and shut your work day off! 

Sound familiar?  The good news is you are not alone. The bad news is you are doing it to yourself in multiple ways. When I work with new 

this seems to be a common thread among them. I’m going to share three of the top reasons for end of workday exhaustion and how to change them.

You are not aware of what is important to you and why it matters

I’m not just talking about what’s important to your business and its goals. I’m talking about what’s important to you as an individual. Every one of us operates from a set of values that are internal and very personal, but they are a part of every decision we make and our way of being. One of the first things I do with new clients is a Core Values exercise to help my client discover what those are and what they mean to them. Chances are you know some of your core values, but are less familiar with others.

When time is spent operating outside of alignment to what’s important to us it shows up in many ways. For example, you might become stressed, agitated, or you might get angry. Stack enough of these together and you are tired and fed up at the end of the day. I suggest taking a look at what was behind those feelings and ask yourself what is important about that to you. Then you have the ability to make changes.

More from Mindy:	How to cultivate an environment of authenticity in your practice

For example:  Let’s say you have a team member who consistently interrupts your day with questions. They are valid questions so you take the time to answer them thoroughly now rather than fixing mistakes later, but you get more frustrated and agitated with each interruption. Before you know it, you are angry and not sure why. After some reflection you determine that it frustrates you that the team member doesn’t try to find the answers on her own first and that she does not seem to be respecting your time. In this example which of your values are not being honored?  It could be time management, a job well done, or resourcefulness. What else could it be?

Thoughts from Anastasia Turchetta:	Taking accountability for your image ... and your actions

Knowing the value and why it’s important allows us to approach things differently. 

The next time the team member comes to your door with something that doesn’t need immediate attention you might say, “Team member, I appreciate that you want to make sure you have the right answers and I’m glad you feel comfortable coming to me. I have this project I need to focus on, so how about if you start with what YOU think you should do, and if you get stuck set it aside and we can meet at 2 p.m. to discuss. Sound good?”  When you take this approach you are honoring what is important to you and your values first, while still serving your team. Try it and notice what happens to your day.

You don’t balance your energy account daily

Every single experience we have in our day does one of two things:  it either feeds us or drains us of energy. When I hear clients say they’re exhausted or they’re looking for balance the first thing I ask them to do is keep track of what feeds and drains their energy in some type of log format daily for a week. They make a + sign for feed and – sign for drain. It might look something like this:

·  Hearing my favorite song on the radio 

·  Putting out office fires first thing in the morning 

·  Enjoying a piping hot cup of coffee at my desk +

The idea is that nothing is too big or too small to make note of and the act of keeping track will make you more of aware of what you want more or less of in your day. Chances are your list of things that drain your levels will be easy to come up with. Challenge yourself to come up with 25 things today that feed your energy account and keep building on it. If your day is starting to fill up with things that drain your energy, you’ll have big list of things to choose from on the plus side. It’s important to 

For example:  Using the list above, you have some things to choose from when you want to bring more energy into your day. It can be as simple as taking a quick break for a 

, taking 10 minute walk at lunch, or making a playlist of your favorite songs for your morning commute. The key is to balance the energy in your day like you would your checking account. It’s all about debits and credits and you have more control than you realize.

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Admit it. You are busy. Of course you are. You are a leader at home and in the office. People depend on you. You go through each day handling what needs to be handled, checking tasks off of your list that have been completed, and finding solutions to problems that have not manifested… yet. You do it all.

. When was the last time you took a few seconds to actually celebrate that completed task list?  When was the last time you took 15 minutes in the morning to set your mindful intention for the day?  When was the last time you embraced your leadership role and empowered a team member to work on a project that you know would be done perfect if you completed it yourself?   Taking time to feel our emotions, to be mindful, and to show up as the kind of person we most want to be is an important part of self-care and make a drastic difference in your day.

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  For the next three days I want you to do three things: 

 Start your day thinking about what a great day would look like. How do you want to feel at the end of the day?  What would have to happen?  What is different?

 At the end of your day jot down ten of your 

 for the day, big or small. Everything counts. If your list is bigger… GREAT!

 Make a conscious effort to genuinely appreciate and boldly empower someone else

At the end of the three days, notice what’s different. How do you feel?  What changed?  What were your challenges?  What will you do different next week?  The power is in the awareness, but we only achieve strong awareness when we slow down and allow ourselves to just be.

There is a long list of reasons why you are exhausted at the end of the day. I’ve listed three of the ones that I see most when working with my clients. We can’t control everything about our day, but when we focus on what we can control the results can be powerful.

Challenge yourself to think about how you WANT to feel at the end of the day and incorporate the changes listed in this post. Take time to notice how your day is different. I’d invite you to share your thoughts and ideas in the comment section so we all might learn.

Trending article: Hammering the two dental hygiene F-words

Wishing you days filled with energy, feelings of being productive, and showing up like the leader you want to be remembered as. 

Mindy Altermatt is a professional coach, speaker, and leadership champion. She offers her coaching programs to dental professionals who want to create balance and purpose in their role as a leader. Her convenient and practical virtual business allows her to work with professional clients located across the country. As a former practice administrator herself, Mindy understands the unique challenges that dental professionals face and can offer a unique perspective when working together with her clients to create strategies and plans that generate rapid results. Connect with Mindy on 

. Contact her at mindy.altermatt@gmail.com or visit her on the web at 

Articles

 It’s the end of your workday and you are about ready to walk out the door. You would ideally like to look back on the day and feel energized, productive, and confident in your leadership accomplishments but you don’t. Instead, you are exhausted! 

3 reasons why you're exhausted at the end of the work day

	The absence of recommended toothbrushes and dental supplies in the marketplace can lead to frustration for patients.

 recommend a small-headed (size 30 to 35) soft 

 to lessen the assault on the cemento-enamel junction. A regularly used toothbrush should be replaced at regular three-month intervals, but, being difficult to find, are often used much longer. However, patients are seeing other, more easily obtainable and rarely recommended items in the marketplace, including size 40-60 toothbrushes, hard bristles and battery-operated toothbrushes – all of which can strip tissue off the cortical plate with a few uses.

Part one of this series: A size 35 soft toothbrush: Missing in action (Part 1)

, I made some recommendations for ways hygienists could enhance patient shopping success when looking for recommended items. Here are some techniques to take this a few steps further and ultimately put those select and valuable hygiene items into your practice’s stock room.

Given the difficulty patients experience locating size 30 or 35 soft toothbrushes, hygienists can proactively visit the nearby grocer or drugstore and request special orders. If numerous requests for a particular dental item are made, the store will start to carry them regularly. Tell your patients which stores carry the items you recommend. My aunt loved the EZ Thru floss holder but could not find them anywhere until she visited a store on the advice of her dental office. At that store, she was able to order an entire box of them, ensuring she wouldn’t run out of her favorite dental tool.

Another difficulty for patients is locating and operating recommended automatic toothbrushes. Hygienists are aware of the technology and science of high-quality automatic toothbrushes, but finding the most cost-effective or specific recommended model is challenging for patients. I once worked in an office as a temporary fill-in hygienist that stocked the lowest-priced travel edition of the Oral B Braun automatic toothbrush. When a recommendation was made for the need for better oral hygiene and the patient was willing to pay the nominal fee for the Braun, we were able to unwrap the brush and give on-the-spot instruction for optimal use. Hands-on instruction at the time of recommendation was vastly more effective than sending the patient to a store to balk at the steep prices and get confused by a large selection of brushes. Large warehouse stores often carry these low-end forms of the best automatic toothbrushes on the market. This dentist bought them by the crate. This really set the bar in patient customer service for me. It also alleviated two problems for patients: Locating the brushes and using them correctly.

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A common practice in many offices is the inclusion of a premium automatic toothbrush in a package plan for patients who have been diagnosed with disease and need full-mouth periodontal therapy. Consider stocking lower-cost automatic toothbrushes and recommend them to patients that desire or need better oral hygiene. This recommendation may seem like an expensive undertaking, especially if you have difficulties with hygiene products expiring on the shelves, or the inability to locate products. Traditionally, a non-hygiene member of the team has managed hygiene supply ordering, but responsibility and management of this aspect of the practice may create a new role for a hygienist in your practice. Goals for this new hygiene responsibility would be to remain at or under budget for hygiene supplies and ensure that prescription products are being recommended and sold in a timely manner.

For missing-in-action products, be proactive and make that trip to a local store to order some size 35 soft toothbrushes, stock automatic toothbrushes for the utmost in customer service and consider growing your practice by giving a hygienist some management duties. Your patients and the dentist’s accountant will thank you!

 The absence of recommended toothbrushes and dental supplies in the marketplace can lead to frustration for patients.

A size 35 soft toothbrush: Missing in action (Part 2)

American Dental Educators Association (ADEA)

 formed a committee charged with assembling a glossary of terms for dental educators. Their labors were published in 

July 2010 Dental Clinics of North Americas

. They found this necessary because the teaching of dentistry had changed in light of 

CAMBRA-Caries Management by Risk Assessment

The words used were from a time when surgical treatment was the only option for dental diseases. Redefining words in light of the current science was overdue. Some changes that occurred redefined words and gave a framework to instructors and clinicians alike. The word “

 was defined and declared as obsolete. “Watch” would no longer be used as a term that educators can teach in the context of this century.

 is very comfortable with “Watch” being obsolete. We have products and support that allow enamel healing, brush biopsies of minute visible changes, and ways to detect and treat a periodontal infection before it destroys bone, so there’s no good reason to passively 

 anything. We have a great scientifically minded group of people who know that watching is not helping, and every little defect can be treated or a protocol administered.

Sometimes we have to go backward to go forward. Take a look at these words -- 

caries, restoration, prosthesis, and diagnosis

. Since you’re a program graduate, there’s probably never been a reason to look at the definition of those words in your daily life. You found a definition that works for you back in school and you’re using it, right? Why not act like it? No definition of caries includes the phrase 

 (as we discussed last time). Yet when a tooth presents with a cavity in it, from whatever cause, fluoride is the first treatment that comes to mind … and too often it’s the only treatment. Caries is a bacterial infection that manifests as damaged enamel as does GERD.

Restoration is a word we routinely swap out for prosthetic in dentistry. The words should live in the two different worlds of dental hygiene and dentistry. Dental hygienists restore the mouth to health and dentists place prosthetics to restore function. Not many dentists want anything to do with prosthetics. However, they don’t mind placing restorations. The questioning nature of millennials forces this wordplay into the foreground. Industry has provided oral health care practitioners with the tools and means necessary to restore the oral flora and enamel back to health. We now have to alter our language to be more accurate.

In medicine, there’s a diagnosis and a treatment. An appendectomy is the treatment for appendicitis. In dentistry, we skip over the diagnosis and go right to treatment, as if every diagnosis were identical. This lack of diagnosis, the 

 of the condition that needs the treatment, has really kept our profession in the dark. We’re still doing dentistry and dental hygiene too much like we were doing it in the 1980s. Sure, we’re using loupes, seeing more patients more often, but we’re still scraping hard deposits off of teeth with sharpened instruments and 

 patients on how to keep their teeth a lifetime. All are treatments. Looking for a diagnosis first, a reason why the teeth are decaying or a periodontal lesion is presenting, is how we can better relate treatments to or patients. They’re expecting that from us.

Related: 4 reasons Modern Millennial Hygienists	should track their production numbers

We’re now living in an age when our understanding of disease, mixed biofilm, obesity, and foodstuffs that are altered at the genetic level has changed in the last generation. Our knowledge base changes twice a generation, so jumping to treatment without diagnosis is dangerous and expensive. Is that periodontal condition exasperated by a food allergy or sleep apnea, or an undiagnosed tongue tie? Is that cholesterol profile out of sorts because of the inflammatory load caused by an untreated periodontal infection that includes a fungus that is growing in the periodontal biofilm? Those are burning questions that should be asked by the oral healthcare provider.

Related: 5 downtime activities to show you are an indispensable Modern Millennial Hygienist

There you have it … the 5 words that need to be redefined and their true meaning needs to be dusted off and internalized. When you ask why an oral condition has arisen and make a proper diagnosis, you will be amazed by the rise in treatment acceptance. With increased treatment acceptance comes increased income. Millennials like a paycheck as much as anyone else, that’s certainly something they have in common with the Boomers and Gen Xer’s.

Next time, we will look at what BOP does or doesn’t mean and delve further into compensation. We look forward to your thoughts and comments.

 In 2008, the American Dental Educators Association (ADEA) formed a committee charged with assembling a glossary of terms for dental educators. Their labors were published in July 2010 Dental Clinics of North Americas. They found this necessary because the teaching of dentistry had changed in light of CAMBRA-Caries Management by Risk Assessment. 

The 5 new words of dental practice ... and what you should know about them

	There’s no question that Patti DiGangi and Shirley Gutkowski shook things up when they wrote their article, “

3 reasons why a Modern Millennial Hygienist does not perio chart

.” The article by these two respected dental hygienists took social media by storm and was passionately discussed by their peers throughout the country.

, Anastasia Turchetta, RDH, revisited the article with DiGangi and asked for some of her thoughts on why it was a topic that drew so many responses.

“We were trying to get across that there are some things you have to think about differently and the ways that you can do that,” DiGangi said. “There is a feeling out there that sacred cows sometimes can’t be challenged. I don’t understand that. Everything should be challenged and examined and I think it’s important for our profession to do that.”

DiGangi also talked about why she and Gutkowski began the 

“It all boils down to a state of mind,” DiGangi explained. “It’s like the old saying goes, ‘How do you eat an elephant? One bite at a time.’ That’s important to us and to the dental hygiene profession … we have to see where we can change things and how we can do it. Ultimately, it’s about what is best for our patients and that’s the thing we have to all keep as the goal at the end of the day.”

More from Patti DiGangi:	CDT 2015 shifts and coding tips every dental practice should know

You can hear more of Turchetta and DiGangi discussing the controversial article, the future of Modern Millennial Hygienists, and more in the latest edition of Straight Talk below.

 There’s no question that Patti DiGangi and Shirley Gutkowski shook things up when they wrote their article, “3 reasons why a Modern Millennial Hygienist does not perio chart.” The article by these two respected dental hygienists took social media by storm and was passionately discussed by their peers throughout the country.

Straight Talk: Revisiting a controversial article and the importance of the Modern Millennial Hygienist

"The only way to make sense out of change is to plunge into it, move with it, and join the dance." -- Alan Watts

Change happens … change in our patients, the way we practice, the products we use, and the choices we make to expand our career. When deciding whether to plunge into the entrepreneur “dance” or choose another path, consider reflecting on four things for your success.


	The decision to be an entrepreneur is a bold one. After all, it almost sounds glamorous, kind of like how traveling sounds … until you experience delays, cancelations, zero priority with an airline, lost luggage, or a cab ride that rivals your worst passenger experience ever!

Ask yourself what your message will be, who will be your audience, what platform will deliver best, and then be bold in your actions to accomplish it. Stand by your decision while remaining flexible. It is in this space that you will be open to learn more about your skills and how to hone them.

RELATED: Anastasia's 5 hot dental hygiene topics for 2015


	It would be great to be liked by everyone, but that is not reality. Say this out loud, “Being respected trumps being rejected.” Be respected for your character, passion, image, brand, leadership, and expertise.

Anastasia asks if you're willing to grow yourself to grow your paycheck


	It will happen. You will get let go from a project. If you work with corporate America, there will be decisions or leadership you will not agree with and you will have colleagues “talk.” There’s no way around it … it will suck.  This is part of the dance. How you respond reinforces your level of boldness as a business owner and empowers your ability to persevere with a strength you didn’t know you had!

Anastasia dishes on 3 things that have made her a better hygienist


	Speak it, show it, and take time to recognize it daily. Surround yourself with people who live it.

May those of you who choose this route embrace the ride! Look at change as a dance and join in!

I’d like to thank you for giving me this opportunity to be your editor. Until the next time we meet … “Take What You Learn & Make A Difference With It!”

 "The only way to make sense out of change is to plunge into it, move with it, and join the dance." -- Alan Watts

4 characteristics dental hygienists need to become successful entrepreneurs

	Mass media face tight restrictions on time and space. There are limited minutes to deliver the message in a fast-changing, ever-more complex world, and the tendency can be to oversimplify.

Oversimplifying complex issues and giving simplistic answers can feel like the best choice; the saying “If all you have is a hammer, everything looks like a nail” can apply here.  This concept applies to other industries as well. In dental hygiene with our limited minutes, care often falls into two almighty, seemingly unchallengeable f-words: Floss and fluoride.

Trending article: Navigating uncharted waters for your dental practice in 2015

When you say you are as dental hygienist, how many times has the response been, “I didn’t floss?”  Advertising seems to indicate the permeation of fluoride into most dental products is the golden ingredient to oral health. The public now believes, based on our constant hammering, that everything can be solved with floss and fluoride.

Hammers are useful tools but only if they are used for the right purpose. There is nothing better than a hammer for driving nails, but nothing worse for cleaning glass or scratching your back. When it comes to patient care, it’s time to rethink and discover more than just the dental hygiene F-words.

Dental caries is a transmissible bacterial infection of the teeth resulting in white spot lesions, cavitation and potential tooth loss

 It sounds simplistic but it is very different from traditional cariology. Dental caries is a pH imbalance of normal 

 on the teeth. This means that caries balance is an ever-changing and requires monitoring. Yet over and over in the presence of the infectious outcome-cavities, an immediate oversimplification starts. The hygiene f-word – fluoride – is automatic solution. Caries infection is NOT a shortage of fluoride! It’s time to quit seeing fluoride as our only or best option. It is an arrow in the quiver, yet deciding which arrows match the individual patient is best based on risk-assessment and diagnosis – the “why” of the infection.

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In 2012, many dental professionals were upset with a 

 (AHA) that poured cold water on the idea that periodontal disease contributes to heart disease. The statement was the supported by the 

. How absurd? Could this be? As hygienists, we know that if someone flosses they can prevent heart disease. Though few us will go that far, our communication seems to indicate that if they entire world flossed, we would have world peace.

The AHA statement clarifies the difference between causality and association. Causality means there is irrefutable proof that one entity is consequence of other. Association means they share characteristics and possibly risk factors, yet one does not necessarily cause the other. The question of whether a clinically significant association exists between periodontal disease and heart disease has tremendous importance.

Research continues to evolve almost daily, yet the real message here is again oversimplifying the complex. What risk factor assessment and diagnostic tools are we using to make the diagnosis? Was a diagnosis made?

More often, a huge leap is made to the f-word as part of our treatment plan. The patient must floss to reach and maintain periodontal health. Floss is an arrow in the quiver yet deciding which arrows match the individual patient is best based on risk-assessment and diagnosis – the “why” of the infection (didn’t we say that already?).

More from Patti DiGangi and Shirley Gutkowski: What Modern Millennial Hygienists need to know about  allergies

Millennials are a generation of individuals who are consuming content in tiny, multimedia-saturated bites

If you have ever used Twitter, you know 140 characters means you have to be concise. That means you have to know exactly what you want to say and say it in as few words as possible. Millennials have discovered more concise ways to communicate. It does not mean oversimplifying. Concise language forces us to exercise our vocabulary; it can make us better writers. It also has the opportunity to make us more concise thinkers.

	Check Out Health Podcasts at Blog Talk Radio with 

Next time, we will explore the 5 new words for dental practice. 

 Mass media face tight restrictions on time and space. There are limited minutes to deliver the message in a fast-changing, ever-more complex world, and the tendency can be to oversimplify.

Hammering the two dental hygiene F-words

	Over the past 30 years, I have often been thwarted in my attempts to locate a size 35 soft toothbrush in a grocery or drug store, so I can imagine the frustration patients feel trying to follow my home care recommendations at home. 

 do exist, but for patients they are missing in action; available in the marketplace somewhere, but not where they actually shop. It’s no wonder they look so forward to the goody bag at appointment’s end.

Additionally, I have faced difficulty supplying each patient with the exact products for their individualized home care, as stocking the supply room with the plethora of choices can be financially challenging for any dental practice. Adding to the challenge are individual state’s regulations that do not allow dental offices to stock prescription hygiene products, stock in bulk or sell products such as 

Trending article: Anastasia Turchetta's five hot dental hygiene topics for 2015

Many hygienists have been stymied trying to steer patients in the right direction for 

. Rather than allowing the marketplace to dictate your patients’ oral hygiene care, be assertive in your search for oral hygiene products you provide or recommend to patients: 

, paying particular attention to articles that discuss the science of home care and prescription products; ask dental supply sales representatives to share samples of products that benefit your patients; and attend dental conventions and search out vendors with product samples available. 

It is wise to sample products so that you can give first-hand advice on their use and palatability. It is helpful to have firsthand knowledge of products before passing on products or recommendations to patients and dentists, as an unpleasant taste or smell may stop a patient from using a product more than once.  

Finding the elusive toothbrush (and other hard-to-find products) may require an active search of your community resources. To get started, create goals that involve reconnaissance at the local grocer, drug and warehouse stores as well as online searches. Check the grocer and drug stores nearest your practice for toothbrushes, toothpaste, floss and additional adjunctive home care products and check the dental supplies at warehouse stores for automatic toothbrush specials.

Rarely will these searches yield an actual size 35 soft brush but knowledge of what is stocked is invaluable and as a side benefit it is possible that, if asked, your local retailers can special order products. Many of the best OTC products are found online but research involving cost and availability will be necessary to encourage patients to purchase and use the most effective products.

The last step in loading your dental hygiene product arsenal is to create a catalog of resources for your hygiene department. Your catalog should list websites, specialty stores, grocers and drug and warehouse stores that carry recommended favorite home care products. Consider gathering and regularly updating this information to alleviate the frustrations of both patients and dental care providers who find so many recommendations missing in action.

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