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Struggling with a Difficult Patient? Here’s How to Manage 4 Difficult Dental Patients

In any business, there are customers that we like and customers that test our patience. The same goes for the patients that visit the dentist’s office.

 

And sometimes, it’s hard to handle them so that they have the best experience and you can do your job.

 

Here are 4 types of patients that can be difficult and how to manage them.

 

 

1. The Google Expert 

 

We all know that one patient.

 

They know all the latest and greatest medical news and can’t wait to share with the dental hygienist. Instead of giving them a cleaning, we’re bombarded with questions that have taken four years of dentistry school to learn.

 

“Why didn’t you use this treatment?’

 

“Shouldn’t you be doing this?”

 

It can be exhausting.

 

It’s wonderful that the patient is enthusiastic about getting involved with the process, but it can hinder dental hygienists’ trying to do their job and sometimes even be harmful to the patient.

 

So, what’s the best course of action?

 

Be firm with the patient and confident in your own education. It’s important to make sure that they know we have their best interest in mind and that we are a much better resource than anything they can find on the web. 

 

2. The Late Comer

 

It’s 3:50. Their appointment was at 3:30. At this point, we’re assuming they just aren’t coming.

 

That’s when they stroll on in. The only thing more frustrating than that is if it happens on the regular.

 

Lateness has a domino effect. Regardless if all the next patients are on time, there’s no way to get back that 20 minutes. The worst part is making other patients wait just because someone has chronic tardiness. It isn’t good for anyone.

 

The best way to manage lateness is to incorporate a late policy. And stick to it.

 

Anyone that is more than 15-20 minutes late to their appointment, cannot be seen that day and will have to reschedule.

 

Generally, patients will respect the set appointment time and it will reduce the amount of late arrivers.

 

3. The Nervous Patient 

 

Dental anxiety is no joke. Nearly 1 in 5 patients have some degree of dental anxiety.

 

As dental hygienists, no one wants to see a patient cringe and tense as we recline the chair or pull back their cheeks. But no matter what we try to do to calm them, nothing works.

 

Sometimes, their discomfort and tension can radiate onto us, making us nervous too.

 

The best advice is to stay calm yourself. This is much easier said than done but often times what you put out into the world you get back in return.

 

It may be beneficial to open up the floor to a discussion about what is causing the anxiety and how we, as hygienists, can ease that discomfort. By knowing what makes them the most worried, you can avoid or minimize that factor.

 

In extreme cases, the patient may need to consult their doctor for anti-anxiety medication to take before appointments.

 

4. The Chatty Cathy 

 

You love them, but at the same time they can be quite frustrating.

 

These are the types that will get to know you, ask about the kids or about upcoming vacations. They are often the sweetest patients you’ll get!

 

As much as they make the workday go by faster, they can eat into the appointment through their conversations and suddenly we’re behind schedule!

 

It can be challenging when managing a Chatty Cathy because we don’t want to be rude in any way but we also have to get the job done on time. But like any skill, managing chatty patients comes with time and experience.

 

Focus the conversations towards the beginning and end of the appointment as well as during the period of time before the patient is seen by the doctor. These time zones are optimal for conversations because they don’t interrupt your job but also give the patient a chance to socialize.

 

Not only that but it will also build a better relationship with the patient!

 

While these four types of difficult patients can pose a challenge, there’s nothing we, as dental hygienists, can’t handle.

 

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6 Reasons Why Privately Practicing Dentists Aren't Going Anywhere

There are many corporate-style dental practices cropping up, and plenty of advantages to being part of a large-scale dental service. But despite many smaller practices being scooped up, you can rest assured that privately practicing dentists aren’t going anywhere!

 

Why?

 

There is a lot to gain by remaining small! The freedoms that come with your own practice can benefit staff and dental patients alike.

 

1. Customer Service and Individualized Patient Care

Private dental practice has roots in the community. The smaller the practice, the more opportunities to create and maintain meaningful relationships with your dental patients. These connections are priceless and a huge advantage over corporate chatbots and AI customer service interaction.

 

While a corporation may push for quotas, introductory offers, and discounts ruled by their budgets, often at the patient’s expense—a privately practicing dentist will always be looking out for their patients’ best interests.

 

2. Human Resources

Having a solid, experienced team you can trust is key to delivering quality dental care. You have to rely on your team and be able to collaborate well in order to be successful.

 

As a practicing dentist running your own clinic, you have the ability to make any personnel changes you feel are necessary. It’ll be your responsibility to hire whomever you want to get a good group of team members that click together. You’ll have the freedom to implement your own policies, health benefits, bonus structure, and training programs.

 

3. Management

Nothing is more frustrating than having management make decisions that ultimately affect your patient’s care. As an employee of a large corporation, you would need to abide by the company’s rules, whether that means replacing your personal assistant or backing one brand of supplier exclusively over another.

 

However, the freedoms of owning a private dental practice do come at a price. There is all the hiring and firing, scheduling, insurance filing, accounts receivable, and other management decisions that go into running a business. To accomplish these tasks, you can hire an office manager that you feel is the most knowledgeable and who’s thinking is in line with your own.

 

4. Marketing

Being the master of your own marketing campaign offers huge rewards. You may be up against some large established dental corporations that have huge marketing machines, but you also have the freedom to share your own unique story. As a private practitioner, you can choose how to market yourself and stand out from the crowd.

 

5. Third-Party Vendors

The quality of dentistry you can provide is not always determined by skill alone. Dentistry skills rely on hardware, software, and a variety of consumables used to deliver high-quality dental care.

 

Running your own practice allows you to choose your own vendors by price and quality of service. It allows you to try out new cutting-edge techniques, equipment, and strategies. Additionally, you would not be constrained to a specific theory of dentistry and limited to only the techniques and treatment plans that the practice selects.

 

6. Your Goals as Privately Practicing Dentist

You’ve worked and studied hard to become a dentist. Becoming a cog in a large corporate dentistry wheel may not be your idea of success in your field. Starting your day with morning meetings reviewing financial metrics over delivering quality individualized dental care may not be in line with your goals.

 

As a privately practicing dentist, your focus is on making sure each patient receives the individualized care that they need, from taking the time to discuss brushing techniques to an after-hours dental emergency.

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7 Methods of Disposing Dental Waste

 

 

Dental waste management is an important aspect of your dental practice management.

 

Dental waste or bio waste accumulates throughout any given day in a busy dental practice. This clinical waste can include human tissue, bodily wastes, pharmaceutical products, syringes, needles, swabs and so on. Additionally, it may include x-ray fixer, developer and gypsum found in dental molds.

 

As in all healthcare facilities, these wastes need to be disposed of safely without any negative impact on the environment. Health and safety protocols are set to guide these disposal activities.

 

Amalgam Waste

Amalgam – used as a restorative material – is made up of several chemicals bound together by mercury. The removal of old fillings and shaping/polishing of new fillings creates mercury-containing waste that poses a threat to the environment. Mercury has been declared a dangerous substance under the Canadian Environment Protection Act, 1999 and can do much harm if allowed to enter the environment through scrap, vapors, or waste water.

 

A Canada-wide standard states that amalgam traps and filters to collect the waste be implemented as a dental office’s best practice, allowing it to be recycled or disposed of in such a way that it does not enter the sewage system. An approved waste carrier should be contacted for recycling or disposal.

 

Silver-Containing Waste

Used x-ray fixer and developer contains silver and are classified as hazardous under Ontario Regulation 347. Municipal bylaws place concentration limits on heavy metals such as silver entering the wastewater system which can affect aquatic life.

 

A dental practice should collect used fixer and developer solutions in separate containers provided by an approved waste carrier or supplier, who will then recycle or safely dispose. Silver recovery units can also be used to reclaim the silver from the fixer solution. Once the recovery cartridge is full, an approved waste carrier can recycle or dispose. Alternatively, dental practices can switch to digital equipment, eliminating the need for x-ray machines.

 

Lead-Containing Waste

X-ray packets and aprons contain lead which is also classified as hazardous under Ontario Regulation 347. Lead can contaminate the soil and groundwater if disposed to landfill. An x-ray film manufacturer will often provide containers for recycling or disposal through an approved waste carrier. Lead aprons must not be disposed to the regular waste system. Approved waste carriers must be utilized for disposal.

 

Bodily Wastes

Biomedical wastes are also classified as hazardous under Ontario Regulation 347. Bodily wastes may include blood-soaked materials, and human tissue. Extracted teeth, gauze, surgical gloves, and saliva-soaked materials are not included under the definition of biomedical waste provided they do not contain blood.

 

Blood-soaked materials should be collected in yellow liner bags marked with the biohazard symbol and disposed of through an approved biomedical waste carrier. If blood-soaked materials are stored on-site for more than 4 days, they should be stored in a refrigerated area, locked and separate from other supply areas.

 
Sharps

Sharp objects used in a dental practice may include syringes, needles, and other sharp instruments such as scalpel blades and clinical glass and should be separated from any human waste. Sharps containers are puncture-resistant and leak proof and designed specifically for safe containment and disposal of these items.

 

Disinfectants and Other Chemicals

There are many chemicals used in dental clinics for sterilizing, disinfecting and cleaning. Some of these chemicals may be explosive if released to sewers in large enough quantities. Many of these chemicals can affect the environment adversely.

 

Follow the directions on Material Safety Data Sheets (MSDS) for the proper handling and disposal of all chemicals in the dental practice. Contact your local municipality for guidelines on disposal of solvents such as ethers, alcohols, acetone or chloroform.

 

Using less harmful cleaning products and methods can reduce the impact on the environment and the need for special handling of waste in the dental practice.

 

Being Compliant

You can ensure your dental practice is compliant by:

  • Documenting the handling, transfer and disposal of all wastes from your dental practice. It is important that your dental office keeps accurate records and maintains all paperwork up-to-date.
  • Choosing a waste carrier that has a certificate of approval for the transport of hazardous waste which should include multiple waste classes.
  • Using recyclable containers provided by waste carriers where possible.
  • Confirming that the waste carrier complies with requirements under the TDGA (Transport of Dangerous Goods Act) requirements such as labelling and containment.

 

 

 

 

 

 

 

 

 

 

 

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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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