Th 160982

Sinking into a soothing ... cocoon

Oct. 1, 2004
'Spa girl' combines the best of spas and dentistry, and now no one wants to leave.

by Anne Nugent Guignon, RDH, MPH

Patients sense a warm, cocoon-like experience during the perioormatherapy appointment.
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Is it possible to create a dental hygiene experience that makes patients want to come in for more appointments, then beg to reserve all future visits for years to come? What may sound like an absolute fantasy happens every day in a Chicago area dental practice. Debra Grant, RDH, provides a totally unique dental hygiene service that leaves patients pleading for more.

An external exam of the sublingual gland that also covers the ears gives the patient a feeling of safety and comfort.
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What exactly is Deb doing differently? In order to really appreciate how this gifted hygienist has created a special experience for her patients, it seemed appropriate to hear about an actual appointment from a patient's perspective. Here's Sarah's experience.

Traditional lymph node examinations can be performed as a soothing massage.
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Sarah describes herself as "wound-up." She keeps her body and mind at full-tilt with a big dose of caffeine every morning. She always takes the first appointment in the morning. She is ready to get on with her day ... has things to do and places to go.

Acupressure and massage creates a sense of calm at the end of the procedure.
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When Sarah arrived at the office, she was focused on everything else she had to do that day, not her dental hygiene appointment. Even though Sarah comes every three months, dental hygiene visits have always been something to get through - a sidetrack to her productivity, a bump in her road, a chance to lie supine with incongruent thoughts racing through her mind. It certainly was not a joyful experience. The appointment was just another thing to cross off the list.

Deb's perioromatherapy technique includes a scalp massage.
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Sarah had agreed to a perioromatherapy(tm) appointment rather than a routine maintenance visit. She was jazzed about the prospect of a different experience, even though she still felt a bit anxious about what was going to happen.

The patient inhales a rejuvenating oil that perks them up by the end of the perioromatherapy session.
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The office where Deb practices has a rather routine ambience. Her treatment room is not unusual either. When Deb closed the door to her treatment room, everything became hushed. The lighting was dim and soft; relaxing music was playing in the background. After a medical history update, Sarah reclined in the patient chair, which is lined with a massage pad. Deb placed a warmed linen towel on Sarah's chest and something warm on her face. With the massage pad set on a soothing motion and a blanket covering her body, Sarah felt like she was in a little cocoon.

Deb explained that she was going to apply a custom mix of essential oils, a mix that took into account Sarah's nasal allergies and sensitivity to many smells. As she continued to create a soothing atmosphere, she assured Sarah that the process could be reversed at any time. This put Sarah in charge of the experience.

Deb urged her patient to just "experience the experience" and said that they were not going to talk during the procedure. Sarah doesn't really know what made her relax and let go, but she remembers being much less aware of what was happening clinically than ever before.

The oral cancer screening felt like a massage and included pressure point therapy that helped relieve Sarah's chronic sinus discomfort. The water in the ultrasonic scaler tasted wonderful. Sarah didn't recall feeling any root sensitivity during the appointment, which was a bonus. The saliva ejector was in her mouth throughout the entire appointment, an experience that normally annoys Sarah, but it didn't bother her this time.

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Sarah has no idea how long she was in the chair and recalls not even caring. She had reached a state of total relaxation, a state that she admits she rarely attains. Sarah remembers trying to figure out what was so different. Her curiosity was quickly replaced with the thought, "I don't care what's happening, just keep on going." She lost the need to control the appointment, amazed that she did not feel controlled. She merely felt detached, ready to fall asleep.

Close to the end of the appointment, Deb began to speak to Sarah in a soft, comforting voice, reporting her findings and giving her recommendations. Sarah recalls never wanting the appointment to end. She felt refreshed and ready to schedule a zillion more visits.

A "Spa Girl's" roots

So that's Deb's unique gift from a patient point of view. What spurred her on to create such a wonderful, satisfying appointment? The answers are amazing.

Deb lived a fast-paced lifestyle in a very crazy world early in her life. She was married, living in Boca Raton, Fla., and jetting all over the country. But she had been raised with a strong work ethic. So, regardless of the fact that her husband was making lots of money, she still practiced dental hygiene at least one day a week. Her father, a chiropractic physician, raised her with an understanding of holistic and natural values, which included maintaining and balancing the physical, spiritual, emotional, and mental aspects of her life. This Midwestern upbringing kept her grounded despite her rich-girl lifestyle.

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For the last two decades, a sound spiritual and health maintenance program has been a core part of Deb's life. She describes herself as an original "Spa Girl." When she lived in Florida, she would go to a skin care expert on a weekly basis and experience all of the wonderful smells and muscle relaxation techniques while lying in a comfortable chair. Deb realized that these techniques could be done in a dental office. After all, dental hygienists are licensed to perform oral cancer screening exams as well as evaluate soft and hard tissues in and around the mouth. The ideas were beginning to gel, but she needed training.

At that time, a well-known company that made all natural products offered certified aromatherapy courses. This was an opportunity that Deb could not pass up. She completed the rigorous course in six months and understood that pure, distilled oils were critical for the success of her aromatherapy. Deb began an exhaustive search for the perfect essential oils and finally found a source in the United States - a Mormon organic farmer in the Pacific Northwest. As a member of the National Association for Holistic Aromatherapy (NAHA), she continues to learn about changes in this unique field.

She called her company the dentalspa, Inc. Unfortunately, Deb did not trademark the name. She never imagined that what she so firmly believed in could, or ever would, be mistaken for the cookie-cutter spa concepts that many offices are using these days, but this business lesson forced her to redescribe and trademark the unique therapy as Oraspa(tm). An Oraspa appointment incorporates all of her special perioromatherapy techniques, which are a blend of various scientific principles. She limits her work to the head and neck area, the legitimate arena of all licensed dental professionals. Patients receive a customized appointment that is based on their individual needs and takes into account their unique health history.

Deb's perioromatherapy technique uses aromatherapy along with acupressure, music therapy, and techniques that mix up the senses and confuse her patients' neurological expectations. Her father taught her head and neck pressure-point therapy. Deb also consulted a Chinese acupuncturist and a facialist to gain more information about effective massage and acupressure techniques. She sought information from a music therapist and consulted a Feng Shui decorator to help create a relaxing environment, one that would invoke a sense of serenity and free-floating warmth. Each one of these individuals is a member of the Oraspa Board of Advisors. Her goal is to mix up the senses and confuse the neurological expectations by altering the expected stimuli - the stimuli that make patients tense.

Bringing it all back to dentistry

Ten years ago, life got in the way of her cushy lifestyle, and Deb and her two daughters headed back to Chicago. She was thrust back into the workday world, practicing full-time dental hygiene to support the three of them. Armed with the education she fashioned for herself, she approached the dentist she practiced with about incorporating her unique techniques into the dental hygiene visit. Like many people, he found change difficult, but agreed that Deb could try a few new things on willing patients. Over time, more and more things were incorporated into her evolving practice.

For the first two years, she purchased her own oils as she tried out various strategies to enhance patient comfort and relaxation. She became an expert in mixing just the right oils to enhance and complement the experience for each patient. Knowing the right oils and herbs to use is critical. For example, Deb has learned that there are specific oils that can help relieve TMJ symptoms and other combinations that can alleviate migraine headaches. Her extensive education has taught her that it is important to understand which products are detrimental or contraindicated given a patient's particular health history.

Deb understands that her special appointments are not for everyone. The dentist she works with finally tried a perioromatherapy appointment. He was impressed. A few of her fellow staff members who are not comfortable with "touch" do note the postive acceptance by patients. They also love the aromas that come out of the hygiene room. She knows they are proud to watch this phenomena progress.

During the first two years, she didn't receive any extra compensation for her efforts but she knew the stage was set for success. She understood that her technique was still developing. Patients were signing up in droves and the practice boomed from the growing number of referrals.

From that point on, her doctor has paid for all of her supplies. Personally, Deb has benefited in many ways. Some of Deb's most special patients are new mothers who never get a moment's peace. These patients look forward to sitting quietly in her treatment room for the nurturing therapy. Apprehensive patients are candidates for this therapy as well. Other patients who truly appreciate Deb's extraordinary skills are those that, due to economic situations, have never had the pleasure of a facial or massage, but commit to their oral health maintenance on a regular basis.

Since her schedule is always full, she always receives a bonus above her regular salary. In addition, she has negotiated a very flexible 29-hour a week schedule that allows her to spend more time with her daughters. Deb also is in charge of her appointment schedule so she is able to customize the time according to her patients' needs. Appointments range from 30 minutes to two hours.

Increasing awareness about aromatherapy

Deb knows that there are many misconceptions regarding aromatherapy. For example, even though many offices use scented candles to cover up "that dental office smell," candles are not permitted by OSHA and are a serious risk in practices using nitrous oxide sedation. The fumes from candles can be toxic and many of the oils used to scent the candles have not been purified correctly.

Deb is in demand to give presentations that provide a basic understanding about how the Oraspa appointment works. A hands-on section where participants are introduced to a variety of essential oils is a fun part of the program, but attending one of these courses can only acquaint participants with the benefits of using this kind of technique during a dental hygiene visit. This kind of program is not designed to prepare attendees to practice Oraspa techniques. Deb has spent many years studying and perfecting her technique and is concerned that dental professionals who do not have a rigorous education and specific training will place themselves and their patients at risk.

It is important to have an extensive knowledge base regarding certain drug interactions with the herbs and oils. In order to give dental professionals the necessary skills, Deb reserves time to train individual dental practices to provide perioromatherapy appointments for their patients. If a dental practice is interested in her services, Deb begins with an initial phone consultation, which helps her determine if perioromatherapy techniques will fit with the practice philosophy. This is followed by a two-and-a-half day, on-site, customized practice evaluation and intensive training for the hygienist and the rest of the staff on the intricacies of the perioromatherapy technique.

While patients are not charged an extra fee for Deb's Oraspa appointment, some of the offices that she has consulted with do have a different fee for this unique service. Deb's own experience has proven that perioromatherapy can be a very successful marketing technique. Nearly 70 percent of her patients book their dental hygiene appointments for an entire year. They know that her time is limited and they do not want to miss out on this special experience. The increase in numbers of new patients is almost more than her dental practice can keep up with.

Now here's another secret. Sarah is a dental hygienist! She appreciates Deb's skillful approach to treating the whole person. It was really hard for Sarah to recall the specifics of the appointment, other than the fact that it was wonderful. Sarah is convinced that if perioromatherapy can have this type of positive effect on a high-strung hygienist like herself, this technique is destined to work miracles with patients all over the planet.

Wow! Doesn't this make you want to lie down in Deb's dental chair for a first-hand magical experience from this gifted hygienist?

Debra Grant, RDH, can be contacted at (630) 640-0473 or [email protected]. The related Web site is

Anne Nugent Guignon, RDH, MPH, is an international speaker, has published numerous articles, and authored several textbook chapters. Recipient of the 2004 Mentor of the Year Award, Anne is an ADHA member and has practiced clinical dental hygiene in Houston, Texas, since 1971. You can reach her at [email protected] or (713) 974-4540 and her Web site is