Florida hygienist encounters ‘what if’ moments as
she offers preventive dentistry advice as a volunteer
By Linda Meeuwenberg, RDH, MA, MA, FADIA
I am one of many northerners who journeyed to Florida after early retirement. I began my journey, as many do, arriving in the winter away from the harsh cold of Michigan, yet continued to be a Michigan resident. I landed in Winter Park near Orlando and was labeled a “snow bird.” The warm air was therapeutic, and I was able to enjoy the outdoors with walks around the community, golfing, and bike riding.
There is an emptiness to retirement when one has been active professionally (I taught in a dental hygiene program). I saw an announcement in the local paper regarding the Retired Senior Volunteer Program. They were hosting an informative meeting to discuss their programming. I picked up the phone to make a reservation. Little did I know how that phone call would change the course of my life.
Although I was not interested in doing anything related to dental, I quickly learned the needs were great in the Orlando area. Before delving into anything dental related, I served at the museum, a sculpture garden, and the Shakespeare Theater. I began volunteering in a Compassion Center. The director at the center indicated that he never had a dental person offer to volunteer in his program. We set up a program to assist the homeless and low-income families and began a screening program to assess the oral health of children, and to provide oral health education, including how to read food labels. A local pediatrician embraced my work, and we quickly became partners in our mission. He was well informed about the importance of oral health and that it is regarded as the number one chronic disease of children. We enjoyed working together at the Compassion Center for well over two years. He managed the medical clinic.
The opportunity at the Compassion Center led to additional opportunities with various agencies. I was contacted by local civic organizations. Most indicated that they never had a person from the dental profession offer their help. I volunteered with the Hispanic Health Initiative, founded by a retired Puerto Rican attorney from New York City. The organization was centered on prevention of chronic diseases. Monthly health screenings were offered to identify and educate the Hispanic community in Central Florida. The organization was staffed by volunteers from a local university, community college, vocational school, and concerned community members. Faculty and students worked each month on the screening days to take blood pressure and vital signs, draw blood, conduct hearing and vision screenings, etc. Nurses provided education and helped the clients devise a plan for better health outcomes. They also offered a health care expo, featuring a variety of tables presenting health information and screenings. I served as a volunteer staging an oral health table and recruited others to help, including some dental hygiene students.
Throughout my volunteer activities I noticed several similarities. The clients served had basic deficits in oral health knowledge and had preventable caries and periodontal infections.
It was an eye-opening experience for me as I interviewed the clients about their oral health history, concerns, and guided them to local providers that could help. Teaching basic preventive measures was welcomed, and they left with a plan and with donated oral care products. Many had issues with language, transportation, income, and lack of insurance. I referred them to the local dental hygiene clinics at the colleges in the area, as well as the health department and public clinics.
I was shocked at the lack of understanding about the basics of oral health and the amount of misinformation they had learned such as, “It is normal to lose your teeth as you get older.” They were grateful for the help and samples of oral care products donated from various companies.
The next opportunity was at an assisted living home that led to several more facilities contacting me. Florida has numerous and varied living quarters for seniors. They eagerly seek informational programs for their residents. I worked mostly with the higher functioning seniors who just needed basic information. I loved working with them and even met a couple of women who were widows of dentists.
The What If Moments
The seniors were thankful for the presentations, the free oral care products, and indicated they learned a lot from the presentations. I often wondered: What if? What if I could discover products that addressed their needs and had a mild flavor that didn’t distress their friable tissues? Several commented that they did not use toothpaste as it irritated their vulnerable mucosa. Many questions were entertained during and after each presentation, arousing my curiosity to address their needs as seniors.
Fast forward seven years when I moved to the beaches of Cape Canaveral and Cocoa Beach. I continued to seek out opportunities for volunteering and was not surprised that many senior groups needed speakers, as well as the local Rotary Club and the Chamber’s business lunches. I was invited to give a presentation for the League of Women Voters and for the Retired Federation of Teachers. I serve on the health care committee of the local League of Women Voters. I provide guest lectures to students at the local dental hygiene program, discussing my work in the community as a volunteer.
Once again, my desire to step away from dentistry when I moved did not happen. Five years ago, I attended my first CareerFusion experience in Daytona Beach. This conference was unlike others, and I became inspired to reach out even more. I was introduced to new corporate partners, served as a key opinion leader, and made lifelong friends with many dedicated oral health professionals. Why do I share this history with you?
Throughout my volunteer activities I noticed several similarities. The clients served had basic deficits in oral health knowledge and had preventable caries and periodontal infections. The seniors often reported tooth sensitivity and dry mouth, and many were dealing with the oral effects of radiation and chemo therapy.
Finding Solutions for Seniors
Some of the companies represented at CareerFusion were new to me and offered some exciting solutions to the problems I was detecting in the underserved populations. Perhaps my “what if” questions could be answered. I was introduced to the benefits of xylitol by the representatives from Xlear that manufacture several products under the Spry label. Many of these products solved the problems identified by the senior population I was serving. I learned about nasal products to combat sinus/allergy symptoms, sweeteners that inhibited decay and tasted great—mints, toothpaste, oral sprays for dry mouth, etc. I was excited! I went back to my hotel room that evening and did more research online about benefits of xylitol and how I would incorporate the products into my presentations.
The next day I was introduced to VOCO where the Remin Pro tooth cream was introduced that contains high quantities of xylitol. This got me thinking that I now have another xylitol-containing product to dispense in my volunteer settings. VOCO produces a comprehensive portfolio of over 100 restorative and preventive products. Of course, I was interested in the preventive products. I noticed the unique packaging and ease of use of the fluoride varnish discussed at the meeting. I was also impressed with the variety of yummy flavors (caramel, mint, cherry, and melon). My personal favorite is caramel, and they recently introduced bubble gum.
I took the varnish samples for testing to my friend’s orthodontic practice. I was impressed with the reaction from the staff and patients, particularly about the ease of use and the flavor.
I also had the varnish applied on myself to get the patient’s perspective. Unlike other products that left my mouth feeling tacky, I hardly noticed the varnish on my teeth. One of the staff members appreciated that the product contains no tree nuts, peanuts, corn, shellfish, eggs, milk protein, soy, gluten, triclosan, petroleum, red dye/artificial coloring, saccharin, or aspartame. Many parents have voiced concerns about one or more of these ingredients being used on their children and have denied treatment.
While the primary indication of the varnish is for treatment of sensitivity, it is equally effective in caries prevention. Profluorid Varnish adheres well to moist surfaces unlike most varnishes where teeth must be dry before application. I find this to be a great benefit as many of the people I serve have special needs. It contains 5% sodium fluoride and is sweetened with xylitol. It is considered a second-generation varnish and is available in SingleDose for ease of application, the prevention of cross-contamination and in treating individual hypersensitive teeth. This is a great option for those that have just one or two sensitive teeth.
According to an online CE article written by Shannon Pace Brinker: “The fluoride ion, together with the calcium ions accumulated in the tubules, causes a precipitation of calcium fluoride, which effectively seals the tubules. According to a user survey, over 85% of patients were completely free of pain after only one treatment with Profluorid Varnish. As well as rapidly sealing the dentinal tubules, Profluorid Varnish also causes calcium fluoride deposits to form on the tooth surface. These deposits protect the tooth from acid attacks, promote remineralization and contribute to the long-term formation of fluoroapatite. Xylitol, which has a proven cariostatic effect in addition to its taste-enhancing properties, is also added to the varnish.”
The author encourages senior residents to try new dental products such as Remin Pro (samples on table in photo) by VOCO for desensitization. The author also picked up information about Profluorid Varnish (inset) that she shares with other groups where she volunteers.
I am impressed with the combination of xylitol and fluoride. The flavor is enhanced, and the patient experiences a therapeutic benefit, making acceptance greater than products that patients find objectionable. Fluoride is not just for kids! The benefits to our elders who are dealing with exposed roots and the consequent sensitivity are noteworthy. From my experience, they will be extremely appreciative. They can drink ice tea and eat ice cream again with their grandchildren. In Florida, every day is an ice cream day!
Not only does aging render enamel at risk from years of acid attacks, studies have examined age related morphochemistry changes in enamel. Not until the nineteenth century was it noted that enamel structure consists of hydroxyapatite crystals. They differ from other hard tissue crystals by their larger size. Enamel is the only tissue of ectodermal origin with an acellular structure, exposed to calcification in the absence of blood vessels and nerves. With age the tooth enamel becomes less dense.
My “what if” question has been answered. I will continue to pursue new innovations due to my never-ending curiosity. Never stop learning! Although retired from teaching and clinical practice, I find it fascinating learning about products that can meet the needs of the seniors I serve in Florida via volunteer activities.
I am grateful to companies that support community projects. Not only has VOCO supported my presentations, they have a branch of the company named VOCO Dental Aid serving mission trips around the globe. I encourage you to continue learning and exploring the plethora of products available to address the needs of the patients you serve. The cookie cutter approach leads to burn out and is a disservice to our patients. Your patients will appreciate the individualized therapies you offer to meet their specific concerns.
An added bonus is you will keep your mind active and avoid the boredom of doing the same thing everyday. Curiosity is the key to fulfillment in my senior years and allows me to love this profession as much today as I did as a new graduate. Never stop asking “what if”?
Linda Meeuwenberg, RDH, MA, MA, FADIA, is the founder of Professional Development Association, Inc. and Professor Emeritus of Ferris State University in Michigan. Linda has recently shifted her focus from speaking at conferences, to increase her community activism. She was awarded the 2017 Swann D. Knowles Achievement award by the Florida Dental Hygiene Association for her support of the profession, her community activism, and her continuing education presentations. She is a recipient of the Sunstar Award of Distinction and the Hygiene Hero award, contributor to RDH magazine and Access. Contact her at www.lindapda.com.