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Put on your thinking cap!

Nov. 1, 2005
ue to my name and profession, I’ve become an ambassador for the tiara, which is sometimes given out at various dental hygiene gatherings.
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Due to my name and profession, I’ve become an ambassador for the tiara, which is sometimes given out at various dental hygiene gatherings. Yes, hygienists have been given the name “Princess,” and it is often said with negative implications. Princess describes a woman of royal status or rank, and her tiara is a headdress worn on special occasions. When we work clinically, we wear many hats or thinking caps. View the tiara as your professional thinking cap, where each jewel represents an area in dentistry that helps you educate patients. Place the sparkling tiara on your head and explore how this unique thinking cap operates during a typical clinical day.

When you arrive at the office, you mentally prepare for the day. Whom or what will you encounter? Will you be thrilled at the improvement of a patient’s oral health following periodontal therapy, or will you treat a patient who hasn’t had any form of dentistry in five to 10 years? Will little Billy the gagger’s mother consider not feeding him before sealant placement?

The tiara, though imaginary, is delicately positioned on your head and allows you to focus on which product, service, or incentive will be needed to produce an optimal oral environment. I break my patients into three age groups - age 40 and over is Group 1, age 21 to 39 is Group 2, and age 3 to 20 is Group 3.

Group 1 requires the most from our thinking cap because by this stage in their lives, these patients have heard the lecture about home care many times. They have a “been there, done that” attitude, may have an anxiety toward dentistry, or may have been misguided with treatment. The physical areas to address are blood pressure, medications and herbals and their oral side effects, surgeries such as knee or hip replacements, heart conditions, organ transplants, health conditions that warrant premedication, immune-suppressed diseases, diabetes, cancer to the head or neck region, stroke or arthritis, menopause, and more. Observing for potential signs of skin, lip, or oral cancers or discolorations and assessing nutrition, caries, and periodontal risk factors come into play before our instrumentation even begins! Feel the weight on your head yet?

You should note the mental disposition of patients in Groups 1 and 2, such as anxiety, depression, forgetfulness, and ADD. Each patient will need a different type of education, thus requiring your creativity. Remember, the same old sayings like “Floss only the teeth you want to keep” may not elicit the reaction they once did. My latest analogy for describing the good and bad bacteria from gum disease is similar to the good and bad cholesterol for CVD. I use facts and stats when I compare plaque removal between power and manual brushes. I have samples of toothpaste, floss aids, interdental aids, irrigators, mouth rinses, and gum. I supply visual aids alongside my verbal recommendations. The concept is to encourage and enlighten patients about the body/mind relationship and its role in dentistry.

Group 2 makes our tiara feel lighter because most of these folks are healthy. They may need to be informed about health issues such as pregnancy, cigarette smoking, smokeless tobacco, oral piercing, and alcohol or drug abuse. I never cease to be surprised at patients’ wonder as I explain the relationship between low-birth-weight babies or premature births and periodontal disease in women, as their obstetricians have not informed them of the connection. Smoking decreases our success with periodontal therapy. Patients realize it is not healthy, but they may need to hear new angles about quitting that they haven’t heard before. Oral piercing isn’t just for teens. You may want to use visual aids to illustrate oral piercing gone awry. Alcohol and drug abuse are noticed not only in behavior or smell, but in oral tissues as well.

With Group 3, you can plant a seed and reap the harvest of preventive dentistry. Use another jewel in your crown to open avenues for parents to provide their child with identification (toothprints), protection in sports, emergency save-a-tooth kits, nutritional counseling, malocclusion corrections (orthodontic bands or Invisalign), sealants, caries risk assessments, and self-esteem issues. Gingivitis may rear its head in the form of poor oral hygiene, stress, or birth control pills.

Each group provides us with the everyday challenges of our career. Even if you have known your patients for years and are convinced they have heard it all, I challenge you to give them one informative piece of dentistry to take with them. Look at how dental hygiene has progressed in the last five years alone! What some of us learned years ago has changed indeed.

At the end of the workday, you are exhausted and must think of dinner and other family activities. You prepare for tomorrow’s schedule and assist with any end-of-day duties with the rest of the team. Routine may play a part in professional burnout. Keep the jewels sparkling and avoid burnout by networking at dental hygiene meetings, brainstorming with other hygienists, or joining hygiene forums to refresh your mind. Good examples are Amy Nieves’ and Lynne Slim’s [email protected]. Take what you learn and make a difference with it!

Interestingly enough, the United States is not the only country in which the tiara is synonymous with dental hygienists. I recently spoke at the Masters in Dentistry Extravaganza in Sydney, Australia, and did not know if the tiara would have the same impact with our Australian fellow professionals, but hygienists there feel the same weight upon their heads as we do. It is a small world after all!

Anastasia L. Turchetta, RDH, has been a practicing clinical hygienist for 16 years. She earned both dental assisting and dental hygiene degrees from Allegany Community College in Cumberland, Md. She is an international speaker and maintains membership with SCN, ISN, ADHA, NSA, and AVDS. She has been published in several dental publications, and has co-authored the book “Conversations on Health and Wellness.” Her ability to reignite the dental team’s fire to accomplish optimal patient care attributes to the success of Strategic Hygiene. She may be contacted at (252) 202-9319,, or [email protected].