By DEBORAH J. DOYLE, RDH, BS
In my experience as a dental hygienist of a periodontal practice, I have observed that nearly every patient is in need of a prescription toothpaste, whether due to root exposure, dry mouth, or general susceptibility to caries. While hygienists in general dental practices may encounter resistance when recommending prescription toothpastes, in a periodontal practice patients typically understand that their situation is serious and requires extra attention. Still, it’s important for hygienists to educate patients on the products we recommend, how they work, and why patients must use them faithfully.
It can be difficult for some patients to grasp what makes a prescription-strength fluoride toothpaste so much better than an over-the-counter version. This is where the hygienist’s role as an educator is especially important. I have frequently recommended 3M ESPE Clinpro 5000 1.1% Sodium Fluoride Anti-Cavity Toothpaste because of the added tri-calcium phosphate (TCP) ingredient, which offers many benefits over competitive toothpastes. This product is a 5,000 ppm fluoride toothpaste that “intelligently” delivers fluoride, calcium, and phosphate to the teeth. The specially engineered TCP ingredient works with the fluoride to help strengthen teeth.
Scientific studies have shown that this unique formula remineralizes enamel and repairs early lesions better than other products. This toothpaste also exhibits greater fluoride uptake than competitors, suggesting a greater anticaries potential. But I haven’t simply read about the research behind its success — I have actually seen it work better than any other prescription-strength toothpaste touting the addition of calcium phosphate. Clinpro 5000 toothpaste is an easy-to-use product that gives patients extra protection, and it also has very low abrasion. This is an important characteristic, especially when providing take-home therapeutic products for patients with root surface exposure.
Personalizing Patient Counseling
In my discussions with patients about incorporating prescription toothpaste into their home care, I emphasize the specific points about the product that pertain to how it meets their individual needs. For example, when speaking with a patient who suffers from dry mouth, I talk about how dry mouth makes teeth more vulnerable to caries, and how prescription-strength toothpaste can help protect teeth. With patients who have furcations, I talk about the importance of putting the Clinpro 5000 toothpaste on a proxabrush and applying the product into the furcation area as they perform their normal home care. I have found that patients are not aware of the susceptibility to caries in a furcation and the consequences that come with that.
A high-fluoride toothpaste can also be very beneficial for patients who suffer from sensitivity. While this toothpaste is not officially indicated for the treatment of sensitivity, I have observed that it is highly effective in this regard. It also seems to offer faster relief when compared to other prescription toothpastes. When counseling patients about using Clinpro 5000 toothpaste to fight sensitivity, I’m careful to emphasize that it must be used continually to maintain the antisensitivity benefit. But when it’s used as directed, I’ve found this toothpaste helps reduce sensitivity to the extent that we can reduce the need for anesthesia during perio maintenance visits, and it also helps make the use of an ultrasonic scaler possible. Research has shown that ultrasonic scaling in conjunction with hand scaling is very beneficial, so the ability to incorporate this into an appointment is valuable for patients.
The experience of Katy, one of my patients, exemplifies how much of a difference the toothpaste can make in fighting sensitivity. (See sidebar.) When I first saw Katy, her entire mandibular arch needed to be numbed in order to perform routine cleanings. She had been using a well-known prescription toothpaste and was not seeing as much benefit as I thought she should be. I switched her to Clinpro 5000 to see if the TCP would give her more relief than high fluoride alone. I told her, “Let’s just give this a try,” after exhausting all other options. She used it and very quickly found that it dramatically helped reduce her sensitivity. After three months, we only needed to anesthetize three teeth at her recall appointment.
Many of us have observed that the extra cost of a prescription toothpaste can be a hurdle for some patients, and while this is less of an issue in the periodontal practice, it can still come up. Again, this is a time when the hygienist can help emphasize the importance of the product and how it can help save patients big costs in the long run. I inform patients that although prescription toothpaste costs a little more, the benefits greatly outweigh the cost, which they get to experience for themselves.
When patients need extra help fighting caries and sensitivity, an advanced toothpaste like Clinpro 5000 with the added TCP ingredient can help give patients an extra-powerful tool for home care. When used as prescribed, it delivers noticeable benefits, reinforcing our recommendations and helping motivate patients to continue its use. RDH
Katy’s Story
Katy, a longtime patient of a periodontal practice, had been using a prescription toothpaste for quite some time. However, she suffered from hypersensitivity to a degree that she still needed to be anesthetized for cleanings, and in her daily life Katy avoided many cold foods. After switching to Clinpro 5000 toothpaste, however, Katy soon felt a change.
“In the first couple of weeks I noticed a difference,” Katy says. “After 30 to 60 days, I noticed a big difference. After three months, I actually was at a point where I needed much less anesthesia for cleanings, and I was able to do things such as eat frozen grapes again. It made a significant difference in my day-to-day life as well as with cleanings.”
Katy has since had to undergo a dental procedure that involved etching of her teeth, which caused some sensitivity to return, but she states that she is again feeling an improvement in her sensitivity while using this toothpaste.
DEBORAH J. DOYLE, RDH, BS, graduated in 1998 from the University of Colorado School of Dentistry, Dental Hygiene Department. She has clinical experience in both general and periodontal dental practices. Deborah enjoys the challenge of affecting a positive change in her patients’ dental health. Reach her at [email protected].
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