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How Ultrasonic Scaling Benefits Patients and Dental Hygienists Alike

 

 

Scaling used to be a dental hygienist’s daily grind. But owing to advancements in ultrasonic scaling, the process has become increasingly efficient and effective. Not only is ultrasonic scaling more convenient to the hygienist than scaling with hand instruments, it has numerous benefits to patients’ oral hygiene as well.

 

What is Ultrasonic Scaling?

An ultrasonic scaler is a power-driven scaling device that utilizes ultrasonic vibration to break up hardened calculus deposits on patients’ teeth. The vibration is driven by a generator converts electricity into ultrasonic waves through piezoelectricity or magnetostriction.

 

Once activated, the tip of an ultrasonic scaler oscillates at incredible speeds up to 35,000 cycles per second. The hygienist guides the tip from the coronal to the apical of a tooth, pulverizing calculus so it can be washed away by a coolant spray.

 

Ultrasonic scalers remove plaque through a dual application of mechanical force and cavitation. The vibration of the tip creates pressure waves in the water dispersed as coolant, causing the formation and implosion of atomized gas bubbles. These shockwaves help to disrupt bacterial biofilm and fracture the calculus deposits as they are pounded by mechanical force.

 

The oscillating tip of an ultrasonic scaler is replaceable, with tips of various shapes and diameter available for different purposes. Thicker tips are generally suitable for use with higher power settings to remove heavier calculus deposits, whereas thin tips are used for light calculus or biofilm removal. In any case, hygienists should read the manufacturer’s directions as to a tip’s proper usage.

 

Benefits to Ultrasonic Scaling

Ultrasonic scaling is highly effective in removing subgingival/supragingival calculus from teeth without damaging roots or gum tissue. Other benefits to ultrasonic scaling include:

  • Using an ultrasonic scaler, hygienists can remove calculus from pockets between teeth and gums at probing depths that are unreachable with hand tools (4mm or greater.)
  • Ultrasonic scalers have replaceable, specially-designed tips that can penetrate difficult nooks and corners.
  • Since there are no sharp cutting edges and no ‘scraping’ sound, many patients find ultrasonic scaling is more comfortable than scaling with hand dental instruments.
  • Scaling using an ultrasonic scaler is faster than hand scaling, allowing more time for the hygienist to speak to and educate the patient at the end of the appointment.
  • Ultrasonic scaling is more ergonomically sound, as its power-driven vibration replaces the need to exert lateral pressure on the instrument to remove plaque.

These benefits have made ultrasonic systems like the Cavitron-Compatible Autoscaler the method of choice for many dental practices, replacing other methods power-driven scaling.

 

However, ultrasonic scalers are not suitable for all patients. Notably, ultrasonic scaling should never be used on or near a person with a cardiac pacemaker. Additionally, some patients are apprehensive of power-driven scalers and prefer that their hygienist provide scaling using hand instruments.  

 

Ultrasonic Scaling Technologies: Magnetostrictive vs. Piezoelectric Scalers

Ultrasonic scalers are driven by one of two types of generators: magnetostrictive or piezoelectric. Both can be effective, but there is a learning curve associated with each.

 

A piezoelectric ultrasonic scaler uses transducers to convert electricity into mechanical energy using materials like quartz crystals. The device sends electrical energy to ‘activate’ the material within the handpiece and vibrate the instrument tip at 28,000 to 35,000 cycles per second. The tip vibrates in a back-and-forth motion and only the lateral sides are active.

 

Magnetostrictive ultrasonic scalers like the Autoscaler generate vibratory motion by transferring electrical energy to metal components in the handpiece. The tip operates in an elliptical motion at 25,000 to 30,000 cycles per second. Unlike piezoelectric scalers, all sides of the tip (lateral, face and back) are active in a magnetostrictive device.

 

Questions? For more information about ultrasonic scaling or Sable’s Cavitron Compatible Autoscaler, contact our team of dental experts. We’re always happy to help!

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3 Steps to Handling the Unhappy Denture Patient

 

Patient satisfaction is key to the success of any dental practice.

 

As a dental professional you will do whatever you can to ensure your dental patients are happy, comfortable and pain-free. You know that a dental patient who has a positive experience will keep returning and refer your services to their friends.

 

No matter how well you have prepared them, at one time or another you may have to deal with an unhappy denture patient. A denture patient will have a unique range of concerns over the procedure involved in getting dentures to replace their teeth. Educating your denture patient on what the procedure entails prior to treatment will help to alleviate their concerns. It’s essential to communicate effectively to your patients and manage their expectations.

 

Documentation is important and must be kept with the patient’s records. Dentists should follow the rule that if it’s not documented, it did not occur.

 

Follow these 3 steps to manage a patient that is having trouble adjusting to new dentures.

 

  1. Listen

    • The first and most important thing you can do is listen to your patient. Be sensitive and remain calm while you try to understand the cause of any discomfort or pain.

    • If dentures are new, there is a transition period in adjusting to them. It’s only natural that replacing teeth with false teeth, or dentures can take time to get used to.

    • If the patient is suggesting you did a bad job, and is questioning your professionalism, resist the urge to get angry, and keep your emotions in check.

  2. Assure

    • Assure your patient that new dentures need not be uncomfortable. Make sure they understand that you have their well-being at heart. Identify the problem and suggest possible solutions. Make sure your patient has been given all the necessary information on the proper care and handling of dentures.
  3. Advise

    • Discuss the possible actions that you could take to help your patient. Most unhappy denture patients just want you to solve their problem. Some may push you to waive all or part of your fee. Others may request procedure changes or other concessions. Remember your end goal of a happy patient!

Common complaints from new denture wearers are:

 

Sore Gums

Gum tissues are initially soft and need to time to heal. Gums will become smoother and firmer over time. Gums will continue to shrink and change, and they may need readjusting.

 
Gagging

Gagging can be caused by a few reasons. Dentures may be too loose and move around, or they may be too large, touching the back of the throat. In some cases, a denture adhesive may help. In others, dentures may need to be relined or even remade. A soft lining material can be added to fill up space. This might have to be repeated every three to six weeks until your patient has completely healed, after which final adjustments can be made.

 

Sore spots

Sore spots can be eliminated by grinding down pressure points inside the denture.

 

Dentures Don’t Fit

Over time bones and gums can change and dentures won’t fit as well. A replacement set or modifications can be made.

 

Mouth Infections

Some people who wear dentures get mouth infections such as cheilitis. Cheilitis is a painful infection caused by the overgrowth of yeast, that causes cracking at the corners of the mouth. Stomatitis is also caused by too much yeast and causes small red bumps on the roof of the mouth. Both can be treated with medicine and proper fitting dentures.

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5 Non-Traditional Career Opportunities for Dental Hygienists

 

As dental hygienists, we love what we do! But scaling teeth day in and day out can be tiring to some. Thankfully, our industry has reached a pivotal moment where there are now countless non-traditional career opportunities both in and out of the clinical setting. Dental hygienists are finding themselves leading initiatives, managing teams, advising policy and bridging the medical-dental divide.  

 

If you're looking for a break from your daily routine, consider expanding your knowledge base and transitioning to one of these non-traditional roles.  

 

Myofunctional Therapist  

Dealing with disorders of the muscles, Myofunctional Therapists deal with disorders of the muscles and functions of the face and mouth. It's a program of specific exercises that strengthen the tongue in order to target the facial muscles used to chew and swallow. Myofunctional therapy includes exercises meant to improve the strength of the muscles within the oropharynx, working to reinforce the proper position of the tongue within the mouth. 

 

Sleep specialists use this therapy to improve breathing problems during sleep, especially in children. Moreover, it is used by dentists and orthodontists concerned about the movement of teeth that occurs when the tongue pushes against teeth.

  

Myofunctional therapists are typically licensed dental hygienists or speech-language pathologists and integrated into various clinical care settings. Because there is no governing board overseeing the industry, myofunctional therapists do not necessarily have to be certified, but there are two well-known organizations that do provide certification courses: 

  1. Academy of Orofacial Myofunctional Therapy (AOMT) 
  2. International Association of Orofacial Myology (IAOM) 

Oral Health Practitioner  

Many dental hygienists are passionate about educating others on the importance of oral health. These days, there are many creative ways to bridge the medical-dental divide. Oral health practitioners in various medical settings are vital to the future of our healthcare in Canada. From providing oral health education to nurses to providing preventative and therapeutic treatment, the opportunities in this field are endless.  

 

Brand Ambassador  

Brand ambassadors typically work as independent contractors and usually receive commission based on direct sales. These brand ambassadors tend to use social media to promote their selected brands. If you're interested in sales and promoting dental brands, this career choice could be for you.   

 

Independent Consultant  

Looking to transition to the world of independent coaching or consulting? This path can really take you wherever you want to go!  

Whether it be working one-on-one with a client, focusing on health coaching, motivational or professional career coaching, or perhaps you'd like to take the team approach. This would allow you to work with other health professionals in developing in-house programming to improve patient experience, increase patient revenue and even work to improve customer retention.  

 

Own or Manage a Dental Program 

Depending on where you live, dental hygienists may even be able to own or manage mobile dental programs in non-traditional practice settings. This could include schools, universities, workplaces, hospitals, or even private homes. Do the research: In Ontario, travelling dental hygienists are becoming more and more commonplace.  

 

Author 

Have you worked in the industry for some time? Do you enjoy writing? If you're looking for a change of pace, try submitting a few pieces to a dentistry journal or magazine. Of course, you can widen your horizons so you're not limiting yourself to just dental publications. Other avenues include blogs, local newspapers, and journals geared towards healthcare and medical professionals.  

 

New Chapter 

Remember, you're not limited to your clinical role. If you're looking for a change, why not use your dental hygiene experience to explore a more non-traditional opportunity and enjoy your new chapter! 

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7 Truths About Hygiene School to Remember When It’s Getting the Best of You

 

Late-night study sessions. Lifelong friends. Stress, tears, and anxiety. And, above all, the satisfaction of pouring it all into a hard-earned degree in dental hygiene.

 

When Kara Vavrosky looks back on her time in hygiene school, those are a few of the things that come to mind.

 

Most dental hygienists would concur. Dental hygiene school is a rewarding experience, of course – but at times, it’s also a gruelling one.

 

From the writings of hygienists who’ve been there, here are seven truths about hygiene school to reflect on when you’re feeling the pressure.

 

1. It Pays to Be Organized

By now, you’ve learned that dental hygiene school isn’t like other post-secondary programs. The coursework is dense, the deadlines come fast, and the practical fieldwork leaves no room to play catch-up.

Put simply, procrastination isn’t an option.

 

Kara Varovsky, who wrote about her experience in Today’s RDH, admits she spent more time in her first week at hygiene school staring at the books and assignments than sitting down doing them. To keep up, she had to make a concentrated effort to begin tracking and prioritizing homework and exams.

 

Keeping to-do lists and assignment sheets might just feel like more work at first, but it can save a lot of time and stress in the long run.

 

“If you’re having a really tough time, take it one day at a time until you can handle taking it week by week,” Kara suggests. “Ask yourself, “What do I have to get done by tomorrow?” It makes everything feel achievable when you break it down and don’t look too far ahead.”

 

2. Some Stress is Normal

Few registered dental hygienists would deny there were times that hygiene school pushed their limits, especially in the first year.

 

It’s completely normal to feel overwhelmed in the beginning. But as the weeks and months pass and you gradually find your footing, hygiene school will become far more manageable.

 

Kimberly Rorstrom-Wittig, a hygienist in Prince George, British Columbia, encourages dental hygiene students to keep looking forward. “Keep focused on your goal and remember that you are all reaching for the same endpoint, to become a dental hygienist.”

 

However, it’s important not to ignore the toll stress can take on your mind and body. As Jason Skazyk, an RDH in Winnipeg, writes: “One of the things that I encourage each student to do is to look after your physical, mental, and spiritual self. Dental hygiene can be a demanding career physically, and if we do not look after our bodies, all that scaling can begin to take a toll.”

 

3. Mentors Make Life Easier

Whether it’s a classmate, an upper-level student, an instructor or a graduate, all hygiene students can benefit from the support and advice of a trusted mentor.

 

Don’t hesitate to ask your colleagues for tips and advice. Even students in the same year as you may have hints and strategies you hadn’t considered.

 

Heather Britton, who practices in Carleton Place, Ontario, urges hygiene students to look for mentorship opportunities everywhere – even those outside the hygiene profession.

 

“The dentist can offer you knowledge on procedures that the books can only describe, by showing you the stages of restorations, prosthetics, and extractions,” she writes. “The dental assistant(s) offer a wealth of information on radiographic techniques to open that tough contact, ordering procedures, and lab techniques, to mention a few. The receptionist can also aid in telephone etiquette, computer booking, and filing systems.”

 

4. Trust Your Instructors

Why do we have to fill out pages of classifications and descriptions for every patient in the clinic?

 

Why so many competencies, rules and requirements?

 

Why won’t my instructor just give me a straight answer?

 

If you’ve spent a few weeks in hygiene school, you’ve probably asked a few these questions yourself.

 

At times, hygiene school can feel overly strict, repetitive, or just plain confusing. Frustrating as it may be, it’s all designed to prepare you for practice. Your instructors aren’t just there to teach you practical know-how, but to impart professionalism and critical thinking skills. All three are essential to becoming a registered dental hygienist.

 

Think of it this way: every obscure term you memorize and head-scratching conundrum you solve goes towards making you the best hygienist you can be.

 

5. You’re Not Alone

“My fondest memories from college days were the camaraderie of all of us,” writes Jan Krawchuk, an RDH in Windsor, Ontario. “We had a class of 20, and many of us would get together for study clubs.”

 

There are so many benefits to joining a study group in hygiene school. Not only does it get you to study at regular intervals (instead of cramming the night before a test), but to share and discuss what you have learned beyond the level of memorization.

 

6. Don’t Compare Yourself to Your Classmates

School isn’t a race. Everyone develops different skills at different paces and having a slow start doesn’t mean you cannot excel as a dental hygienist.

 

It is often tempting to compare your progress to that of your classmates. As a recent graduate, Lana MacDonald knows from experience that it’s not a useful exercise.

 

“My advice to dental hygiene students is not to rush the learning process,” she says. “Don't worry about competing with other students. Work at your own pace and learn everything the ‘right way.’ It will make things easier when you go out into practice even if you may feel behind in school.”

 

7. Don’t Forget to Have Fun

Whether you choose an accelerated program or a four-year degree, dental hygiene school is a significant part of your life. Take the opportunity to make friends and create memories you’ll look back on fondly.

 

“Always strive to do the best you are able to do, but remember to enjoy this time in your life,” advises Nancy Mar Hoffos, an RDH in Alberta. “When the opportunity arises to have fun, take it, or when you reflect back, you will have regrets.”

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Motivational Interviewing in Dental Hygiene

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?

 

At least one registered dental hygienist says the answer is yes. Writing for Today’s RDH, Michelle Strange explains how she came to see her role as a hygienist differently.

 

two ladies shaking hands

 

Clinical Care vs. Self-Care

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.

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Assissting Stroke Patients with Oral Hygiene Care

The occurrence of a cerebrovascular accident (CVA), commonly known as stroke, has a significant impact on a patient’s oral health. Dental hygienists can provide valuable support in the maintenance of oral hygiene as survivors recover and adjust to life after a stroke.

 

Oral Hygiene

 

This article provides an overview of the role of hygienists in assisting stroke patients with oral hygiene care.

 

Stroke and Oral Hygiene

Cerebrovascular accident (CVA), commonly known as stroke, affects millions of people each year. It is the fifth leading cause of death for Americans and the third for Canadians. In some cases (particularly in elderly patients) stroke causes severe and lasting disability.

 

Patients typically undergo extensive rehabilitation, including occupational therapy. Traditionally, it was physical therapists that helped patients regain oral hygiene skills following the incidence of a stroke.

 

However, cuts to healthcare benefits have resulted in many patients receiving less rehabilitation and little to no assistance in overcoming the challenges stroke can present in brushing, flossing and general oral self-care:

  • Loss of coordination (apraxia) can make brushing and flossing difficult or impossible;
  • Difficulty swallowing (dysphagia) can increase the time food spends in contact with the teeth;
  • Facial paralysis (hemiplegia) can cause food debris to accumulate in the affected cheek without the patient’s knowledge;
  • Difficulty articulating (dysarthria) hinders communication between the patient and dental professionals.

Additionally, many of the medications used to treat stroke survivors present side effects that further complicate their dental care:

Each cerebrovascular accident case is unique; not all patients who are recovering from stroke present the same conditions or follow the same path in recovery. However, dental hygienists who wish to support these patients must be knowledgeable of the many ways stroke can impact the state of a person’s dental health and the ongoing care they require.

 

Assisting Stroke Patients with Oral Hygiene Care

Oral hygiene is an important part of a stroke survivor’s care and recovery. Regaining the ability to care for one’s teeth and gums gives patients a sense independence and control over their health.

 

For patients with lasting disabilities, dental hygienists can help empower the patient’s caregivers to provide quality dental care.

 

In most cases, patients are advised to wait at least six months after a stroke to receive non-urgent dental care, and to receive a post-CVA consultation with the patient’s physician. These are some of ways that dental hygienists can assist stroke patients with oral hygiene care:

  1. If the patient uses oral hygiene aids at home, have the patient bring the products to the appointment and demonstrate their use. Hygienists can advise on the usage of these products to achieve the best possible results.
  2. Hygienists can suggest products and methods that can help patients compensate for the loss of dexterity or cognitive impairment, such as floss holders, floss piks, electric toothbrushes, and brushes with a two-minute timer.
  3. Patients who suffer from xerostomia as a side effect of medications can be given products and tips to help relieve dry mouth
  4. For patients with cognitive impairment or memory loss, hygienists can assist by providing all oral hygiene instruction in both oral and written form and including the patient’s caregiver in all appropriate discussions.

 

Celebrating Dental Hygienists

October is National Dental Hygiene Month: an initiative to celebrate the hardworking, compassionate dental hygienists who contribute to the cause of improving oral health care. Sable Industries is proud to support your work.

 

We look forward to assisting you.

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Treating the 4 Common Dental Problems During Pregnancy

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?

 

commin dental problems during pregnancy

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.

A comprehensive overview of research on this subject demonstrated that associations exist between periodontitis during pregnancy and pre-term birth, low birth weight babies, and preeclampsia.

Common Dental Problems During Pregnancy

In particular, there are four oral health conditions that become more prevalent during pregnancy:

  1. Gingivitis
  2. Dental caries/cavities
  3. Pyogenic granuloma
  4. Dental erosion

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.

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Why Dental Hygienists Should Perform Extraoral Head and Neck Examinations

Caries. Gingivitis. Ulcerations. Bruxism. These are among the common ailments dental hygienists watch for in every routine dental examination. But there are some areas of inspection many hygienists overlook: namely, the oral structures of the head and neck.

 

Dental professionals, including hygienists, omit conducting an extraoral head and neck examination on patients on a routine basis. However, head and neck examinations can save lives, as they are key to identifying signs of oral cancer.

 

Importance of Extraoral Head and Neck Examinations

When oral cancer is detected and treated in its early stages, the 5-year survival rate is as high as 90%. However, because it often develops without pain or symptoms, patients rarely notice the disease until it has progressed into Stage 2 or beyond.

 

For this reason, dental hygienists and other professionals can greatly improve patient outcomes, or even save lives, by incorporating head and neck examinations as part of routine dental examinations.

 

Dental professionals conduct extraoral head and neck examinations by palpating important structures of the patient’s head and neck to assess and identify abnormal conditions. A thorough examination involves palpation of the jaw joints, parotid salivary glands, thyroid gland, masseter muscles, and various lymph nodes (submental, submandibular, cervical, supraclavicular, occipital, postauricular, and preauricular lymph nodes).

 

It is not necessary to perform these checks in any exact sequence, but the clinician should choose a sequence and apply it consistently to maintain awareness of abnormal versus normal conditions.

A well-practised clinician can complete this examination within four to five minutes.

 

How Dental Hygienists Can Perform Head and Neck Examinations to Improve Patient Outcomes

Unfortunately, many dental hygienists do not conduct thorough  head and neck examinations on patients.

 

The Canadian Dental Hygienists Association (CDHA) identifies various barriers that stand in the way: lack of time, insufficient training or knowledge, concern about client compliance, and lack of guidelines and tools.

 

But the capacity of these exams to improve outcomes for patients is too great to ignore. Dental professionals can potentially detect up to 84% of new oral cancer cases in the critical early stages. And, as demonstrated by an anecdote told by TGNA Clinical Coach and guest columnist Karina Bapoo-Mohamed, these 5-minute examinations can save lives.

 

Bapoo-Mohamed advised her patient to see a doctor ‘sooner than later’ after discovering an abnormality. Within days, the patient was referred for treatment for stage 1 oral cancer.

 

“Everyone that asks how/why I had it checked,” writes the patient, “and all I say is thanks to my Dental Hygienist.”

 

The CDHA sets out the following steps dental hygienists can take to improve their practice when it comes to extraoral head and neck examinations:

  1. Know the facts on oral cancer. Dental hygienists should be confident in their knowledge and ability to locate, review, and update baseline data.
  2. Know the early signs to look for. Perform extraoral head and neck examinations in addition to other routine dental exams. Use this fact sheet from Canadian Dental Association as a starting point for educating yourself on the signs of oral cancer.
  3. Effectively communicate findings to patients. Ensure that patients understand the urgency of identifying and treating a potential case of oral cancer in the early stages.
  4. Refer patients appropriately. Dentists and dental hygienists should establish a process for referring patients who could have oral cancer to a doctor who can conduct a biopsy.
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Dental Office Design

 

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.

 

Dental Office Layout

 

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.

 

Visual Distractions

 

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.

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4 Tips to Prevent Chairside Burnout

 

Everyone has a bad day at work from time to time. But if you find yourself feeling physically, mentally and emotionally drained on a regular basis, you may be on the road to chairside burnout.

 

Chairside Burnout

 

It’s not hard to see why dentistry has one of the highest burnout rates of any profession. While rewarding, the work of a dental hygienist can also be enormously stressful. Hygienists often deal with long hours, tight schedules, and fussy patients in a fast-paced, high-pressure environment. One study found one in eight dental hygienists leaves work feeling emotionally exhausted by the demands of the job.

 

Follow these steps to prevent stress from leading to full-blown chairside burnout.

 

1) Know the Signs

 

Stress is hard to miss, but it’s not always as easy to see a burnout coming. The daily marathon of cleanings and consultations leaves little time to stop and think about yourself. Recognizing the signs of burnout is the first step to preventing it.

 

Burnout is marked by feelings of hopelessness, cynicism, and resentfulness. Once stress takes its toll, a normally-cheerful hygienist may start to become impatient and critical. The job may feel less rewarding or purposeful than it did in the beginning. Enthusiasm is replaced by a lack of energy, leading to less productivity. Some people suffer unexplained headaches or other physical complaints.

 

If you can relate to these signs, take time to gather your thoughts and reflect on your career as a dental hygienist. Try to understand where your negative feelings are coming from. Is it the physical demands of the work? Frustrating office politics? Lack of work-life balance? Like a bad toothache, you can only treat the problem once you’ve found the source of the pain.

 

2) Take Care of Yourself

 

Self-care is important in any career, but especially so for dental hygienists. You must make time in your busy day to do things that help you replenish your emotional energy, like walking the dog, taking a long shower, gardening, or listening to your favourite album. Use this time to focus on the present moment and practice positive thinking.

 

Since being a hygienist is physically demanding, it’s also important to take care of your body. Cardio is proven to help reduce burnout, and light exercise can help reduce the muscle and joint strain. If you’re feeling the burn, ask your doctor about physical therapy or other treatment for work-related injury.

 

3) Maintain a Work-Life Balance

 

Your work as a hygienist is important, but it doesn’t have to define who you are. Don’t fall into the trap of making life all about your job. If you’re constantly thinking about being chairside, even on your days off, you’ll only accelerate the burnout effect on your career.

 

Having things to look forward to outside of work is key to avoiding burnout. It can be something structured, like a college course or a sports league, or a casual hobby like photography. If you’re starting to feel burned out on the job, try something new in your off-time to instill new energy in your life.

 

4) Connect with Other Hygienists

 

It’s said that engagement is the antithesis of burnout, but when you’re having difficulty at work, it’s easy to forget why you pursued this career in the first place. People who experience chairside burnout often lose sight of the things they loved about being a dental hygienist.

 

One of the best ways to stay engaged in your work is to network with other dental hygienists. Your colleagues know the ups and downs of dentistry better than anyone. Sharing stories and advice will help you broaden your knowledge and keep in touch with your passion for dentistry. You can connect with others through online groups and forums, continuing professional development events, and your local hygienist association.

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