Periodontist agrees with authors
Aloha RDH:
Two fine articles in the November 2004 issue of RDH caught my eye, namely Trisha O’Hehir’s article on residual bleeding following treatment, and Deborah Lyle’s and Carol Jahn’s article on perio-systemic links.
O’Hehir hammered home the need for effective plaque control immediately following treatment. Therapists too often overlook this need. The need for thorough and consistent post-treatment supragingival plaque control applies across the whole range of periodontal therapies, from uncomplicated prophylaxis to periodontal surgery.
Lyle and Jahn correctly noted that most of the perio-cardiovascular disease links are not proven - rather that epidemiologic evidence suggests associations. Indeed, a key question remains unanswered, namely: Does treating oral infections improve cardiovascular prognoses? It will be some time before we know the answer to this.
However, it’s important to put Lyle’s and Jahn’s paper in perspective. Billions of dollars are spent each year on cholesterol control - yet the small print in the statins’ (Lipitor, Zocor, and Crestor, for example) advertising (sometimes) points out that these drugs are, so far, not proven to reduce cardiovascular events among patients who have no history of cardiovascular disease. Moreover, statins can have significant side effects and are far from cheap. Moreover, I know of many healthy physicians and others who take statins based on the likely assumption that these drugs will help prevent initial cardiovascular problems like heart attacks. In this context, and in light of the trivial-to-non-existent side-effects associated with any among the full range of periodontal therapies, it makes good sense for dental professionals to err on the side of caution (that is, aggressively controlling periodontal infections) rather than risking error on the other side - the side that may kill or cripple.
Bottom line is that it’s prudent to warn patients about these links - and mention to them that while they are not fully proven, it’s probably not worth taking the chance of being wrong. Chronic inflammation appears much more problematic than most of us were trained to appreciate.
Get a periodontist on your team!
Mike Rethman DDS, MS
Diplomate, American Board of Periodontology
The benefits of diet and excercise
I couldn’t agree more with Julie Hagan’s “Get Moving” article (September 2004 issue) on the importance of diet and exercise in our careers as dental hygienists. I have more than 25 years of experience as a dental hygienist, only taking time off in the early years to have my three children and nurture them in their young lives. The role that diet and exercise have played in my life has been significant, having been a mainstay since my early twenties.
From time to time, I have to deal with some repetitive motion issues, which chiropractic care can adjust quickly. Regular exercise helps to make the adjustments easier.
It also makes a difference to practice using ergonomic equipment. I work with an ergonomic chair and use loupes. However, I have a cautionary note regarding loupes. Take care that you are fitted with the correct declination angle when positioned in your optimal working position. My first pair of loupes were not at the correct angle, and they forced my neck to be positioned improperly. I developed neck strain as a result.
A well-exercised body makes it easier to maintain proper working positions. A healthy, strong back will naturally strive to be straight, not slouched or improperly positioned when treating patients.
I’ve tried many different exercise programs but I have practiced daily yoga for many years. Yoga has kept me strong and supple, providing me with a long life of preventive care in many ways. I like to think of yoga being to the body what flossing is to the teeth.
The connection between overeating and our emotions - the fact that we often eat to hide pain or to feel pleasure - is important to realize. Dieting by itself won’t work unless a lifestyle change in eating healthfully accompanies the dieting.
An individual needs to feel better about herself or himself and exercise is considered to be the number one reason dieters feel better about themselves. I would like to interject a different perspective on how to feel better about oneself. This perspective is about changing on the inside - about knowing who you really are and being at peace with yourself. When one knows this inner peace, exercising and dieting may become a natural result of caring for oneself. Fortunately, diet (not dieting) and exercise have been a lifelong pursuit of mine. It has also been a life of searching for the peace within. I know that my career as a dental hygienist has been enhanced because I can relax in the moment and let go of much of the stress that hygienists deal with so often. Being able to let go and relax in the moment has added more to my career as a dental hygienist than any other factor.
For anyone interested in learning more about this inner experience of peace, I encourage you to access www.contactinfo.net or www.tprf.org.
Pamela Thurston, RDH
St. Johnsbury, Vermont
About the cover
Editor’s note: Several months ago, we asked writers associated with RDH if they wanted to nominate who appears on the magazine’s cover. In the November 2004 issue, Cathy Seckman’s sister was the cover model. Seckman is a feature writer whose articles frequently appear in the magazine. This month, columnist Anne Guignon’s choice of Ellen Neuenfeldt appears on the cover.
Ellen Neuenfeldt, RDH, BS, is the perfect example of diversity in dental hygiene. Clinical dental hygiene has always been the center point of her passion about our profession. Even though Ellen has held a full time position with 3M ESPE Dental Products Division in St. Paul, Minn., for the past 16 years, she still practices one night a week in a local general practice. She loves the patient contact and the opportunity to connect with her professional roots on a regular basis. Her continued participation in the clinical world keeps her grounded about the issues, joys, frustrations, and satisfaction found in dental hygiene practice. In addition, it gives her a unique opportunity to evaluate new product ideas or services with the other dental hygienists in the practice.
According to Ellen: “One of the greatest joys that I receive from practicing clinical dental hygiene is the interaction with each patient. I always feel that in some way, either great or small, I have made a difference for that person. And, it’s not just about advising them on their oral health. It might be talking about something personal in their lives, such as a recent divorce, loss of employment for either themselves or a spouse, or a health-related situation of a family member. It’s the connection between the patient and clinician that goes beyond the basics; it’sthe caring and empathy that we can give our patients which is so often absent in our society today.”
Ellen received her dental hygiene degree from Northeast Wisconsin Technical College in 1977 and like many hygienists today, she pursued her bachelor’s degree some years later and received her degree in Business Management from Stritch University in 1994. She has been involved in various functions within the 3M ESPE Division that range from technical projects to sales and marketing. Currently, as a professional relations manager, she maintains a focus on several areas of dentistry, with her favorite being preventive dentistry. In addition, she creates and maintains relationships with the ADHA, AAPD, and other professional associations. Ellen has published a number of articles in several dental hygiene journals, and presents educational programs on various aspects of preventive dentistry. In 2004 she received the Outstanding Dental Hygienist Service Award from the Minnesota Dental Hygienists' Association.In addition, she has represented 3M ESPE at the RDH Under One Roof Conference, participating in every conference since its inception.
Ellen and her husband Dale reside in Lake Elmo, Minn. Both love outdoor activities, and together have created a spectacular perennial garden full of colorful spring and summer flowers. Ellen and Dale enjoy trail riding on their Rocky Mountain horses, a breed known for gentleness, a smooth ride, ease of training and willingness to please. Ellen and her horse, Sporty, often go on solitary trail rides, and she enjoys the one-on-one time. "Being outside, enjoying nature with my favorite equine companion is a wonderful stress relief after a busy day in corporate America...it just can't be beat!"
Ellen and her husband Dale reside in Lake Elmo, Minn. Both love outdoor activities, and together have created a spectacular perennial garden full of colorful spring and summer flowers. Ellen and Dale enjoy trail riding on their Rocky Mountain horses, a breed known for gentleness, a smooth ride, ease of training and willingness to please. Ellen and her horse, Sporty, often go on solitary trail rides, and she enjoys the one-on-one time. "Being outside, enjoying nature with my favorite equine companion is a wonderful stress relief after a busy day in corporate America...it just can't be beat!"
—Anne Nugent Guignon, RDH, MPH
