What’s your goal as a registered dental hygienist?
Is it to create whiter smiles, or something more?
Hygienists know their breadth of skills and knowledge extends far beyond simply cleaning teeth. Registered dental hygienists are in a unique position to connect with patients and impart personalized dental advice that can benefit them for years to come.
Unfortunately, a dental office operates on a tight schedule, leaving little to no time for hygienists to talk with patients one-on-one.
This raises an important question: is it worth spending less time on clinical care to spend more time on counselling?
Michelle Strange is a practicing hygienist, surgical assistant and educator. She is also a self-proclaimed perfectionist.
“I need to know I am doing the best job I can while striving to do it better,” she writes. “Sound familiar?”
In the beginning, Michelle felt she was making the most of her limited time with patients by eradicating every last stain on their teeth. She still took the time to give thorough home care instructions, of course – but if there were a minute to spare, she’d rather have used it to deliver additional clinical care.
That all changed when she discovered motivational interviewing.
“If I have to choose to spend 5 minutes getting every speck of stain off of a patient’s lingual surfaces or 5 minutes making sure they can use a toothbrush properly, I choose the latter”, writes Michelle.
It’s a stark difference, but one that Michelle feels will benefit her patients far more in the long run. And she’s not alone. Motivational interviewing is gaining ground in the dental profession, with an increasing number of dentists and hygienists embracing the view that what patients do at home is just as important as the care they receive in the dental chair.
What is Motivational Interviewing in Dental Hygiene?
Pioneered in the world of cognitive therapy, motivational interviewing describes an approach to patient care that puts the clinician in the role of a coach or a counsellor more than an authority figure – someone who guides patients in the right direction instead of lecturing them.
In dentistry, this approach can apply to how registered dental hygienists educate people about dental self-care. By asking questions and listening without judgement, clinicians can help patients understand choices that affect oral health and feel empowered to make positive change.
For example, rather than simply cleaning the patient’s teeth, a hygienist would take time to help them understand why the stains occur and answer any questions the patient may have about flossing and brushing.
As Michelle puts it, “Treatment is only going to last so long. If the patient continues to build calculus in the same place every time we see them, are we performing successful patient care?”
When clinicians take a non-judgemental interviewing approach, patients are more comfortable asking questions and speaking honestly about their current dental self-care. The hygienist can then provide personalized recommendations that meet the patient’s level of disease, obstacles to care, and lifestyle.
Motivational Interviewing in Practice
With this approach, you may find that patients are more receptive to your advice and motivated to make positive changes. Start by incorporating the four basic motivational interviewing techniques: open-ended questions, affirmations, reflections, and summaries.
Ask open-ended questions that invite the patient to elaborate, such as: “What do you find works for you in your current home care routine?” and “What do you find difficult about dental care?”
Give affirmations that recognize good choices and encourage patients to continue, such as: “I can tell you’ve been flossing.”
Reflect the patient’s answers in a way that gives them meaning. If the patient says they only want a treatment that falls within their insurance coverage, you could say, “We’ll have to keep dental care within your budget.”
Summarize the patient’s thoughts to confirm their answers and show you are listening.
Motivational interviewing isn’t the only way to approach patient care, but it is one way to ensure they get more from the appointment than a whiter smile.
Communication is the cornerstone of a successful practitioner-patient relationship. Dentists and registered dental hygienists hear this principle repeated throughout their education.
However, in most dental appointments, the practitioner does most of the talking.
If you’re a patient, these are vital questions to ask on your next dental visit. If you’re a practitioner, this list should help open the door to more productive communication with people for whom you care.
1. How Does Dentistry Impact My Overall Health?
There is a strong connection between a person’s oral health and the state of their health overall. Not only does the mouth offer clues to what’s going on in the rest of the body, but it can affect the body in ways patients often find surprising.
2. What is the Condition of my Gums, Teeth and Smile?
Given the connection between oral health and overall health, it is vital patients know where they stand. The appointment should not focus solely on the most pressing problems. Take time to discuss the state of the patient’s oral health as a whole.
3. How Does Your Oral Health Impact Your Everyday Life?
Patients in the dentist’s chair should never be shy about what’s bothering them. Even minor concerns can point to bigger oral health issues that should be addressed. Be sure to bring up everyday issues like swollen or bleeding gums, bad breath, loose teeth, and snoring.
4. How Will a Proposed Treatment Solution Benefit Me?
Part of a dental practitioner’s job is to ensure patients have the facts they need to make well-informed decisions about their oral healthcare.
Some treatments are necessary, while others are beneficial but optional, or purely cosmetic. It’s important that patients understand the urgency of a procedure and the possible consequences (if any) of not moving forward.
5. Is This the Right Practice to do this Work?
Many dentists are generalists, but some specialize in a particular area of dentistry. For certain treatments, patients may benefit from a referral to a specialist in areas like endodontics, orthodontics, or periodontics.
A dental specialist in the United States is a member of a Dental Specialist Organization recognized by the American Dental Association; in Canada, a specialist has completed specific postgraduate training and passed a Royal College of Dentists exam.
6. Is This the Right Time to Proceed with Dental Treatment?
Assuming the problem is not an urgent one, it may be better to postpone treatment until a later date. Many people have a limit on the total cost of dental care their insurance covers each year; performing different steps of treatment over a longer period can help the patient maximize their dental benefits.
The Importance of Practitioner-Patient Communication
We write about communication between patients and dental practitioners on this blog often. In this post, we aimed to help facilitate the process with questions every patient should ask (and which dentists and hygienists should encourage).
If you asked the average parent to name the roster of a prenatal healthcare team, they are bound to mention a few key players: the family doctor, obstetrician/gynecologist, sonographer, and perhaps the midwife.
What about the dental hygienist?
Parents and healthcare providers often overlook the importance of oral health during pregnancy. However, multiple studies have indicated a link between poor oral health and adverse outcomes in pregnancy.
We’ve provided an overview of these four common dental problems during pregnancy, along with how dentists and dental hygienists can play a greater role in providing care to pregnant patients.
1. Pregnancy Gingivitis
During pregnancy, the body’s response to gingivitis-causing bacteria in the periodontal tissue changes. Some studies speculate the change is triggered by hormonal fluctuations, such as increased salivary estrogen levels during the second and third trimesters.
As a result, patients who had periodontitis before pregnancy may find that inflammation increases throughout the pregnancy. Those with no prior history of gum disease may develop periodontitis or notice increased bleeding and gingival crevicular fluid flow.
2. Dental Caries in Pregnancy
The risk of developing dental caries or cavities often increases during pregnancy. Patients may be affected by one or more contributing factors:
Decrease in salivary pH due to changes in diet;
Increase in acidity in the mouth due to vomiting;
Dry mouth; or
Poor oral hygiene care due to nausea and vomiting.
3. Oral Pyogenic Granuloma
Pyogenic granuloma appears as a small tissue overgrowth on the gums that can be smooth or lobulated and red or pink. These lesions are sometimes called ‘pregnancy tumours’ because they are more common in pregnant patients; however, pyogenic granuloma is not cancerous and often disappears without treatment.
Though not harmful, a pyogenic granuloma can be painful and unsightly.
4. Dental Erosion During Pregnancy
Patients who experience morning sickness or gastroesophageal reflux disease (GERD) in pregnancy may develop greater erosion of dental enamel. Although there is no way to reverse dental erosion that has already occurred, dental professionals can assist in preventing and reducing its effects.
Assisting Patients with Common Dental Problems During Pregnancy
Pregnancy can be a critical time for a patient’s oral health. Not only does it increase the risk of these common dental problems, but poor oral health care is linked to outcomes like preterm birth, low birth weight, and preeclampsia.
There are many ways in which dental hygienists can help contribute to positive outcomes through good oral health care at all stages of pregnancy:
Encourage patients to have regular dental checkups during pregnancy, even if they are accustomed to seeing the dentist only once or twice a year. Emphasize the added importance of oral health care during this time in their lives.
Be non-judgemental about new concerns the patient may have about dental treatment during their pregnancy. Many people have heightened concerns about medications, fluoride treatment, and dental x-rays during this time; answer their questions with patience.
Reinforce the benefits of good oral hygiene care: twice-daily brushing for two minutes at a time, once-daily flossing, and using toothpaste with fluoride.
Ask about any new medications or supplements the patient may be taking during pregnancy.
Celebrating Hygiene Month
We all have dental hygienists to thank for being a part of our healthcare team throughout different stages of our lives, including the journey towards parenthood. This is the second in a series of articles we’ve published on this important role during Hygiene Month: a month to recognize hygienists and emphasize the importance of good oral hygiene.
Sable Industries is proud to produce quality dental tools used by registered dental hygienists and dentists across North America. Contact us today to learn how we can assist your dental practice.
There are many ways to boost patient satisfaction in your dental practice. Clear communication, good time management, friendliness, efficiency, and empathy are significant factors in a patient’s overall expectations of their dental experience.
But according to the Canadian Dental Association, one quality stands out above the rest: confidence.
A dental practitioner’s confidence, and the ways in which they demonstrate it, ranks as the #1 influencer on how patients perceive their quality of care, according to the latest Canadian Dental Association survey.
Why? Confident people attract positive attention — no secret there. It’s natural to be attracted to people with high self-esteem, whose confidence shines through their charisma, appearance, speaking, writing, and listening skills. Confidence is a sign of competence, not arrogance, in the dental practice.
To promote and maintain patient satisfaction, professional dental care providers need to keep confidence at an optimum level to ensure ongoing quality of care. Below, we’ll discuss some of the ways to grow and maintain that confidence in your practice.
Ways to Be Confident and Boost Patient Satisfaction
A person’s levels of confidence can swing up and down due to positive or negative experiences, and criticisms. We are most confident when we are performing routine and familiar tasks.
Here are ways to show your confidence as a dental practitioner or hygienist:
Be optimistic. Think positively. While it may sound cliché, there are tangible and proven benefits to adopting an air of optimism, and your positive outlook will rub off on your patients.
Focus on the present. What do you want to accomplish today? Don’t dwell on the past. Once you have acknowledged your mistakes, learn to accept them and move forward.
Accept compliments graciously. Say thank you. What may seem like minor work to you can have a profoundly positive impact on your patients’ lives, so you should always be open to their praises.
Face your fears. When you have a busy day ahead, tackle the tasks you like least first. You will face the remainder with the confidence of knowing the worst is over.
Break down large tasks into smaller sub-tasks. Knowing how to prioritize your to-dos is key to ensuring you accomplish your daily goals.
Learn and research new skills and technology. The world of dentistry is continuously advancing, and being prepared will help you keep a competitive edge.
Recognize your strengths and achievements. You have come a long way to get where you are. Remember to celebrate successes.
Manage stress. Don’t let your own wellness get lost in the daily grind. Develop effective coping strategies, and take moments to just breathe throughout your day.
Smile. Learn to laugh at yourself. Take pleasure in your daily tasks.
Believe in yourself and your team. Positive reinforcement will help everyone in the practice grow their confidence and boost patient satisfaction.
When concentrating on efficiency and making the best use of the available space, it can be easy to forget a dental office also must provide the right atmosphere for clients. Although many dental practitioners have done their best to reduce anxiety for clients, Ondontophobia is still all too real for many people.
While some of these individuals require therapy to manage this issue, practitioners can still do their part to reduce anxiety experienced by anyone dreading a trip to the dentist. A great way to start is by reducing a client’s apprehension before they sit in the examination chair.
Here are some things to keep in mind for dental office design that will help to generate an inviting, relaxed atmosphere for your patients.
In the old days, dental offices often had a tropical fish tank in the waiting room. These provided a gentle distraction for patients, particularly children. Many still do, but now many offices are also installing televisions.
These generally play programs and movies without the sound, but with closed captions activated so interested viewers can follow what is happening.
A TV can provide a relaxing diversion, but you need to be careful about what is on. Violent shows or ones that are particularly suspenseful will be counterproductive, as will news channels on days when the reporting is particularly negative.
Soothing Colours and Artwork
Personal preference always plays a big role when choosing colours for an office, but here are some suggestions to consider. When choosing your colour scheme, aim for hues that induce a sense of tranquility and do not have any hint of threat.
Colours able to bring about a calming energy include those people commonly enjoy in nature, such as sky blue, green/sage, and tan/brown.
White suggests cleanliness and reminds some of anti-septic, but can be triggering for some due to its hospital connotations.
Bright colours, while attractive, can actually put people on edge (red is particularly strong in this regard), so try to stay away from them.
Do not choose only a single colour; pick a main one as well as another that provides a notable contrast, but not too harsh (e.g. a darker and lighter version of the same hue). Solicit opinions from your staff, and ask what they would prefer for areas only they will use.
Artwork can also provide both decoration and visual interest. Be sure to choose art the average person can easily relate to and does not include an abundance of off-putting shades.
Plants and Furniture
Plants will help to reinforce the natural theme and suggest that your practice is a healthy and vibrant place. Be sure to regularly water and maintain them so wilted, dying leaves are never apparent. If it is apparent that everyone on staff is too busy to ensure this happens, hire an outside company to do it.
Choose chairs that look and feel comfortable, but can also hold up well to steady traffic and children. Side tables should be big enough to accommodate patient’s incidentals, but not take up so much space that it becomes awkward to move around.
Include magazine and brochure racks for those who would prefer to read.
Provide a View
If building design permits, and you are lucky enough to be in a picturesque area, provide a window view in the waiting and exam rooms.
This offers another healthy and natural way for patients to get their minds off their procedures, both before and during the process.
You know the basics of oral health care: brush twice a day, floss your teeth, avoid sugary snacks, and visit your dentist at least twice a year. Here are 10 tips for oral health care you may not know (and a good refresher if you do!)
1) Brush Smarter
Which is better: a humble manual toothbrush or a fancy electric one? They can be equally effective, but what really matters is your brushing technique.
Don’t just brush up and down or back and forth. Hold the brush at a 45-degree angle and use a gentle, circular motion to clean each surface of the teeth, including the chewing side and the side facing your tongue, for at least two minutes. Brushing harder or faster doesn’t do you any good. In fact, it can actually lead to tooth and gum damage!
2) Don't Forget to Floss
People often think flossing is secondary to brushing, but they are both essential to good oral health. If you aren’t flossing, you’re leaving a third of the surface of the teeth unclean.
The ideal flossing technique is a forward or backward motion, with the floss forming a curved ‘C’ shape around the tooth. Use a fresh part of the floss for each tooth so you aren’t re-inserting the bacteria you just removed.
3) Pay Attention to Sensitive Teeth
Sensitivity to heat and cold is a common dental complaint, and it’s often a sign of an underlying issue like tooth decay, gum disease, or tooth grinding. It’s important to find and treat the source of tooth sensitivity, even if the pain is mild. See your dentist at the first signs of sensitive teeth.
4) Eat Well and Brush Often
You’ve heard it since you were a kid: sugar causes cavities. True, a diet high in sugar can lead to cavities, but the real cause is plaque, produced by bacteria in your mouth that eats the carbohydrates left on teeth after a meal.
While sugar is the biggest cavity culprit, even healthy food leads to some plaque formation. This is why you should brush after every meal, not just after dessert, and avoid eating or drinking anything, aside from water, after you have brushed your teeth at night.
5) Watch Your Fillings
Do you have fillings? If so, you can usually expect them to last for eight to 10 years. However, some fillings break down earlier than that. When a filling starts to chip and break apart, food and bacteria can get caught underneath, causing decay deep in the tooth. Be sure to make a dental appointment if your tooth filling is not holding up.
6) Wear a Mouth Guard
Mouth guards are standard equipment for contact sports like hockey and football. However, less confrontational sports—such as baseball, skiing, and skateboarding—can also pose a risk of injury to your teeth. Even minor dental injuries can lead to long-term consequences, so a mouth guard is a good investment for anyone who participates in a sport on a regular basis.
7) Read the Ingredients on Toothpaste
What’s in your toothpaste? Different kinds of toothpaste—those for desensitizing, tartar control, whitening, et cetera—consist of different active ingredients. Understanding how these ingredients work will help you choose the right toothpaste for you. You should always choose a toothpaste containing fluoride, even if your tap water is already fluoridated.
8) Beat Bad Breath
There are many possible causes of bad breath, but poor oral hygiene is a common source. When you don’t brush and floss regularly, odor-causing bacteria can accumulate between teeth and in the back of your throat. However, bad breath can also be a sign of a medical problem, so have a dentist rule out any oral hygiene issues first.
9) Use Mouthwash as Directed
Mouthwash cannot replace proper brushing and flossing, but it can help boost your oral hygiene and control issues like bad breath, plaque, and oral sores. Be sure to read the instructions on the bottle before using it. Depending on the ingredients, the manufacturer may recommend using it either before or after brushing or flossing for the best results.
10) Make Regular Dental Appointments
Do not wait until you have a problem to see your dentist! Even if your teeth and gums seem fine, the dentist might notice things you can’t feel or see. Scheduling regular dental exams will help you detect and treat cavities, tooth decay, gingivitis, and other oral health issues before they become painful and/or expensive to fix.
Some people find a trip to the dentist quite stressful. This can stem from anxiety, an unpleasant experience with another practitioner, or even a dental accident they saw in a movie or television show. Let’s face it—the thought of a stranger having access to an intimate part of the body can spook some individuals.
Many practitioners already take steps to offer the most relaxing and professional atmosphere possible to allay such fears. However, a recent study by Deva Priya Appukuttan offers additional suggestions on how to help clients struggling with dental phobia and a subsequent failure to maintain oral health through regular appointments.
Here are three of the main points the author discussed.
Get to Know Your Clients
When a practice first accepts clients, they answer a series of questions relating to their medical history, insurance, etc. Appukuttan suggests it is also wise to consider a semi-structured interview. This calm, informal conversation would allow the practitioner to learn more about situations causing fear and/or anxiety. The dentist or staff member could unobtrusively guide the conversation using open-ended questions, rather than direct and potentially off-putting queries.
In addition to learning what situations may cause issues, the dentist might also determine such fears are part of a wider psychological issue and recommend the person to seek out a therapist. This mental health professional may work directly with the dentist to design an approach to help the patient overcome their worries.
In addition to the medical questionnaire mentioned above, practitioners can also offer a second one dedicated to anxiety issues patients sometimes experience. This would act as a confidential way for nervous clients to self-report using a series of questions and a scale mirroring the person’s anxiety. For example, when asked about having a cavity filled, a “1” could mean little worry and a “5” could show great worry.
The dentist could use this knowledge to categorize patients and approach them accordingly. Starting a dialogue in this fashion can help avoid unexpected issues during the moments of a procedure where such an interruption could be problematic.
The rapport dental professionals build with their clients is very important. A busy practice often reduces the amount of time a practitioner can spend with patients, which is unfortunate, as it can lead to an increase in anxiety for some.
Taking the time to listen, answer questions, and map out each step in the procedure can go a long way in reducing a client’s fear. This opportunity to make inquiries and spell out any concerns will increase the person’s respect for the practitioner. It is important to acknowledge it is not unusual to experience some anxiety before a procedure. Make eye contact, avoid any negative word choices, and emphasize you are here to help. All questions are valid; provide detailed responses demonstrating your interest and desire to do a thorough and professional job.
Maintain this dialogue while performing the procedure. Keep the client informed of what you are doing and what the next step will be. Also, ask whether they are experiencing any discomfort and reassure them they are doing well. Be honest and straightforward.
When you visit your dentist’s office, you expect one of the dental hygienists to greet you in the waiting area and bring you to the exam room. It is customary for them to make conversation with you, floss your teeth, conduct a dental cleaning, and then call in the dentist.
Dental hygienists spend a large portion of their workdays in front of patients, primarily cleaning, polishing, and scaling the patient’s teeth. Most people, if asked what dental hygienists do all day, will likely give that as a response. However, there are also some tasks they perform either completely behind the scenes or some that patients simply do not notice during their appointment. Keep reading for the reveal of the four most significant behind the scenes tasks dental hygienists perform during their daily duties.
Checking Facial Expressions
When the dentist is checking your teeth, they are wearing what is essentially a powerful magnifying glass on their eyes. This allows them to really look closely at your teeth and determine things such as cavities, signs of gum disease, et cetera. However, it also prevents them from really seeing your face and facial expressions, which makes them blind to any winces and other signs of discomfort. In many instances, the dental hygienists often observe the patient’s facial expressions in order to determine if everything is going well. Patients are often too preoccupied to notice dental hygienists commonly do this.
Stocking the Office
Every dental office needs a vast array of supplies, including surgical masks, protective gloves, glasses, and the tools used to perform cleanings, suction, et cetera. How do all these supplies and equipment stay in the required quantities at the dental office? This duty often falls to dental hygienists, who stock up the exam rooms and office as a whole when they are not working directly with a patient.
Cleaning the Exam Room
It is necessary to clean exam rooms and sanitize all the tools before a new patient enters for their dental appointment. After all, a dental office is a medical environment. So who cleans the exam rooms in between patients? This is where the dental hygienists come in. In many instances, they have their own exam room for patients, which they will clean and sanitize before bringing another patient back. This usually includes cleaning the chair and the glasses used, plus disinfecting the dental tools (or replacing them with new ones while they undergo additional cleaning).
Reviewing History and Charts
Your primary doctor will often rely on your medical record, which includes notes from past appointments as well as details on any vaccinations you may have received. Your tooth records are just as important to a dentist. In fact, you may actually need to provide information from your overall medical history to the dentist and dental hygienist. Such information can include any medication you might be taking, surgeries you have had, allergies, et cetera. The task of reviewing and updating patient history and charts, including ensuring updated x-rays are in the file, almost always falls to the dental hygienists.