Kate Machado, RDH, BS, MEd, FADHA
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Kate Machado always knew she wanted to be a dental hygienist, but she never expected how much the profession would help her grow into a leader. Today, she’s teaching the next generation to speak up, challenge norms, and build trust through care.
quip: What first drew you to dental hygiene, and what has kept you passionate about the profession over the years?
Kaitlyn: It seems silly, but the chocolate chip cookie dough prophy paste that was used as a child during my hygiene appointments started my interest in dental hygiene. Since then, I always knew I wanted to be an RDH. Different opportunities and always trying to improve myself have kept me passionate in the profession. In dental hygiene school, my professor taught us that we should be life-long learners and I took that to heart. I constantly take webinars, courses, and attend conferences (which I love attending anyways) to continue moving forward as a professional, for my students and patients.
quip: You believe that words like “cleaning” shrink the scope of what hygienists really do. What’s an example of how changing our language can change how patients (or even teams) respond to care?
Kaitlyn: Yes, I believe “cleaning” is an outdated term and minimizes what we do. I use the example when discussing this to my patients: calling it a “cleaning” is like calling a teacher a babysitter, which is not the case at all. I have many family and friends who are educators of all age groups and it’s a lot of work. They do so much behind the scenes. I say exactly that to patients, and they appreciate being educated on this. It shows passion for what we do.
Words matter. This can change the perception and value of treatment. If we say, “you are here for just a cleaning…”, it frames the treatment as “no big deal” and lowers its value. I discuss all the assessments and the reasoning behind what I do throughout the hygiene appointment. For example, during my EO/IO* exam, I evaluate the back of the throat, tonsils, and tongue, and ask questions such as, “do you breathe more through your nose or mouth?” and “do you know if you snore at all? If so, does your doctor know?”
This opens the door for further information about the patient and allows more critical thinking to occur. I am constantly evaluating their health during the appointment, trying to determine why they present the way they do (caused by habits, homecare, medication, etc), what to educate on during OHI,** what specific recommendations and treatment they need.
Bringing a curious mindset to my office has improved treatment acceptance, which improves patient outcomes. I am very appreciative to my office and doctor for valuing what I do and valuing each hygienist, allowing us to have a seat at the table, especially when it comes to patient care.
quip: Many hygienists feel stuck between production pressure and personalized care. What helps you find that balance while still advocating for what your patients truly need?
Kaitlyn: I have found and learned over the years that if you do what you are supposed to do for the patient, based on what they present with, you will be productive. This means using the proper procedure codes (insurance does not dictate the care or treatment we provide) and following the standard of care. Patients are unable to refuse substandard care. For example, if a patient presents with active periodontitis (which is a disease), it will not benefit them (or you) to code them as healthy (prophylaxis code D1110). Educating the patient and collaboration between yourself, the doctor, and patient are key!
There are many other ways to be productive without “selling.” There are adjunct therapies and treatments that can aid in patient care such as fluoride varnishes, antimicrobial varnishes, sealants, salivary testing, or perio trays, to name a few. Being honest, standing up for yourself (and your license) and creating rapport with patients will help them trust you and accept the care they need.
Lastly, I am a professional sample queen. I know how to get samples and coupons for my patients. This helps demonstrate to patients that you care and shows you went above and beyond the standard. I fill my patients’ homecare bags with different products (based on what they need) such as different toothpastes, interproximal aids, oral probiotic lozenges, xerostomia products, tongue scrappers, waterflosser discounts, neutral pH mouthwashes, and tons of coupons!
quip: As an educator, how do you prepare your students to push back on outdated norms while still thriving in traditional practice settings?
Kaitlyn: It can be very intimidating going into the real world. I always tell my students that your first office does not have to be your forever home. Finding a trusted mentor or hygienist within the practice can be a huge benefit so they can feel comfortable asking questions and throwing out ideas. Just because they are new hygienists does not mean they do not bring their own value or voice to the team. That is why going for an interview is so important, as you collect so much information at this step. For me, I used to bring a notebook full of questions so I could make an educated decision. This also included an office tour and shadowing prior to accepting the position.
I emphasize that they know their worth, ask questions, continue to learn, advocate for themselves and patients, follow their gut as they know what is right and what is wrong (this may include not allowing patients to dictate their care as you are the professional). You worked way too hard in dental hygiene school to be put in a box!
quip: How has writing for a professional hygiene platform helped you shape your voice? What advice would you give to others who want to contribute to the profession through content or education?
Kaitlyn: I found this writing opportunity six months after graduating and I submitted a few articles writing about what I was experiencing at the time: interviewing and finding a job. This position has allowed me to grow personally and professionally as I continue to write. It has helped me share my voice and open up as a new leader. You do not have to be the loudest in the room to be a leader. Trust me, I was a very shy child and dental hygiene brought me out of my shell. Doing this has given me so much and I have been able to have so many memorable experiences because of it. Because of this position, I have been able to meet amazing dental professionals across this country, interview trendsetters in the profession, and connect with other professionals who read my articles.
For anyone who is interested in writing, I would recommend reaching out to platforms or magazines you are interested in and submitting work. Getting feedback from editors can provide beneficial tips to improve your work and allow growth to occur.
quip: What’s one clinical skill or habit that you think is undervalued in our profession, but makes a major difference in patient outcomes?
Kaitlyn: Hygienists possess many skills and knowledge that continue to evolve throughout their careers. Two skills that are undervalued are our leadership skills and our ability to provide a “dental hygiene diagnosis.”
Each state has their own scope for an RDH, which dictates if they can provide a “dental hygiene diagnosis.” The dental hygiene scope is a huge part of national advocacy at this time. This involves, importantly, diagnosing periodontal disease. In dental hygiene school, we were taught about the dental hygiene diagnosis, but technically my state does not include that skill in the RDH scope. Hygienists can classify periodontal disease, which is staging and grading patients, but doesn’t qualify as a diagnosis. We possess the critical thinking skills, we collect a thorough assessment, educate the patient, and provide the specific treatment. If we are empowered and trusted to act as the experts and leaders that we are, we can have a true collaboration with the doctor and stop any type of barrier to proper patient care.