Elite hygienists do not emerge from social media quarrels
By Anne Rice, RDH
The dental world is seeing quite an upsurge in social media usage. You can find a job, advertise for an open position, “like” what seem to be thousands of dental-related pages, and enjoy videos on any topic. You can also boost business pages of your own, which may not have a single thing to do with dentistry.
Social media works for a lot of people, but I’m going to present some serious pitfalls for our career and share new motivating science that’s based on information you may use tomorrow at the office. We signed up for this career to help and care for people by offering preventive oral care. Times have changed, so let’s embrace the powerful new science in medicine and dentistry.
Dental hygienists have more Facebook pages than ever before. Some are scientific, some promote small businesses and inventions, and some even champion leaving dentistry altogether. I’m not a Facebook expert, but people seem to need mutual support in their angst. There are plenty of snarky posts, hijackings (people promoting their own businesses), and too many passive aggressive posts. These tend to lead to an unprofessional standard, which in the big picture may lower our wages and increase the substandard business models that are trying to dumb down RDHs. Many hygienists want independence to practice without the many restrictions, and snarky isn’t the way to get it.
Let’s help the public find value in our profession by acting more professional on social media. We can make a change in our business if we all work together with kindness and grace.
Every industry has quality control issues, so to speak. How does griping on social media help anything? It doesn’t help, and it makes our industry look like high schoolers. Dental hygienists are prevention specialists who build relationships, gain patient trust, and ultimately help the whole person. If we don’t believe in this career, how will anyone else?
All of us have times of burnout, but what we do about this burnout makes us who we are. Great things will come for some hygienists if we slow down on social media and spend more time learning about and growing in the advances of dentistry. Updated studies are almost a daily occurrence, and we should all delve into some of these studies.
How does griping on social media help anything? It doesn’t help, and it makes our industry look like high schoolers.
A friend of mine, Cyndee Johnson, coined the phrase “elite hygienist.” This does not mean we should not cooperate with our coworkers. We should not hand off the sterilization of our own instruments or become condescending and act like prima donnas. On the contrary, “elite hygienist” means not only do we do our best, but we continually strive to be more and do more. One of the best ways is to keep up with research about oral pathogens and systemic diseases that are not only bidirectional but causal.
Here are six everyday scenarios to help us with simple and practical scientific-based information that will help our patients achieve the goal of optimal health. Good patient care will not come from spending too much time on social media, but from being informed and hands-on practitioners.
Case 1
A patient, Betty, had a myocardial infarction (MI) 10 months ago. You take Betty’s blood pressure and pulse, and the pulse rate is 86. (Don’t look only at a patient’s BP. Include the pulse.)
One year following an MI, a resting heart rate of greater than 90 bpm is a strong predictor of cardiovascular mortality. “. . . data from a large MI community cohort indicate that heart rate is a strong predictor of long-term all-cause and cardiovascular mortality, not only at initial presentation of MI but also during the first year of follow-up.”1
Here’s what to say to your patient: “Betty, I noticed today that your pulse rate is just under 90 beats per minute. I can write that down for you to take to your cardiologist, or perhaps you can call the cardiologist’s office. I think that due to your previous heart issues, this might be an indicator of other cardiovascular concerns.”
Case 2
Your friend’s mother, who has rheumatoid arthritis, mentions that she keeps missing her dental recare appointments because of flare-ups with her arthritis. Periodontal disease and rheumatoid arthritis are both inflammatory diseases.
“Porphyromonas gingivitis is the most common pathogen associated with periodontal disease... nonsurgical periodontal treatment improves both the biomarkers and the clinical situation of RA.”2
What to say to your friend: “Hey, John. Encourage your mom to get back in for her preventive appointments. The studies show it will help with her arthritis symptoms.”
Case 3
A middle-aged man mentions during his medical history check that he lost 15 pounds recently and he wasn’t even trying. You also notice that he went to the restroom three times during his visit. There may be an explanation for the weight loss and frequent urination—diabetes.3
Here’s what you can say to your patient: “George, I think it would be a good idea if you called your physician to have him or her check your glucose levels. You have a few symptoms that have me a bit concerned.” Do not tell him he has diabetes.
Another way to approach this: “George, we can do a quick glucose test today and look at the results. I would recommend that you make an appointment with your physician and bring in those results.” You can use code D0411 for this test; HbA1c in-office point of service testing.
Case 4
A young woman is sad because her mother has just been diagnosed with Alzheimer’s. The disease is in the very early stages. Her mother has been your patient for 15 years, and you’ve performed scaling and root planing and other protocols on her that have not improved her periodontal status.
In 2011, Judith Miklossy found that four out of five autopsied brains of Alzheimer’s patients had spirochetal (Treponema denticola) bacteria that originated in the mouth. Also, Porphyromonas gingivalis is considered a keystone pathogen that is linked to Alzheimer’s.4,5 I suggest finding out what pathogens you are trying to treat and develop a personal plan to help your patient’s health. Pathogen saliva tests are available to any practice.
Here’s what you can say to the young woman: “How about we try to see your mom a bit more regularly? We can do a simple saliva test to check her bacteria load and help her decrease any pathogens that might contribute to the progression of Alzheimer’s. We really want to keep all inflammation as low as we possibly can.”
Case 5
Your coworker has developed preeclampsia in her second pregnancy for no known reason. Her gynecologist is very concerned that she’ll go into preterm labor. Two years ago she had a stillborn birth and no cause was found.
Porphyromonas gingivalis, one of the red complex oral pathogens in the mouth, has been found in 51% of placentas and 41% of umbilical cords of preterm deliveries, but in only 6% of placentas and 0% in umbilical cord specimens of full-term deliveries. In one study, Fusobacterium nucleatum infection was found to be the causative factor of a stillbirth.6
Case 6
Frank rushes in and has a seat in your chair at 7 a.m. and says this appointment is so early that he didn’t even have time for his coffee. You review his health history and take his blood pressure. It’s high. He tells you he has white coat syndrome.
“ . . . researchers concluded that the risk of developing sustained hypertension was 2.5 times higher in the white-coat group and 1.8 times higher in those with masked hypertension.”9
Here’s what you can say to Frank: “I understand that your blood pressure does read differently in a health-care setting, but studies indicate there is a 2.5 times higher risk for you to develop chronic hypertension. I suggest you get a blood pressure cuff at home. Take your blood pressure first thing in the morning and record those numbers so you can keep an accurate log to give to your physician.”
No one can learn every bit of new health information. It takes productive collaboration between medicine and dentistry, as well as digging deep into our core value of saving lives. Let’s help one another through study clubs, invitations to collaborative informative social media groups, and conversations in our own families. Let’s go more for education and less for the jugular, especially in the numerous social media groups for dental hygienists.
“Great minds discuss ideas. Average minds discuss events. Small minds discuss people.” Eleanor Roosevelt
Anne Rice, RDH, is a graduate of Wichita State University and a member of AAOSH, TXOHC, and ADHA. She recently successfully completed the Bale/Doneen preceptorship course, which solidified her passion to educate and inspire others to improve outcomes by unifying health. She practices clinically in Conroe, Texas. She can be contacted through her website at AnneORice.com.
References
1. Jabre P, et al. Resting heart rate in first year survivors of myocardial infarction and long-term mortality. Oct. 30, 2014. Mayo Clinic Proceedings, Volume 89, Issue 12, 1655–1663.
2. Sotorra-Figuerola D, Gay-Escoda C. 2017. Relation of rheumatoid arthritis and periodontal disease. JSM Arthritis 2(1): 1020.
3. Barasch A, et al. Random blood glucose testing in dental practice. 2012. The Journal of the American Dental Association, vol. 143, no. 3, 2012, pp. 262–269., doi:10.14219/jada.archive.2012.0151.
4. Miklossy J. Emerging roles of pathogens in Alzheimer disease. 2011. Expert Reviews in Molecular Medicine, vol. 13, doi:10.1017/s1462399411002006.
5. How KY, Song KP, Chan KG. Porphyromonas gingivalis: an overview of periodontopathic pathogen below the gum line. 2016. Frontiers in Microbiology, 7, 53. http://www.doi.org/10.3389/fmicb.2016.00053.
6. Han Y, et al. Term stillbirth caused by oral fusobacterium nucleatum. 2015. Obstetrics and Gynecology, Lippincott Williams and Wilkins. cwru.pure.elsevier.com/en/publications/term-stillbirth-caused-by-oral-fusobacterium-nucleatum-2.
7. Ertas E, et al. Detection of incidental carotid artery calcifications during dental examinations: Panoramic radiography as an important aid in dentistry. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, Volume 112, Issue 4 , e11 - e17.
8. Mancia G, Fagard R, Narkiewicz K. 2013 ESH-ESC Guidelines for the management of hypertension. Journal of Hypertension: 31:7: 1281-1357.
9. Kario K, et al. Morning home blood pressure is a strong predictor of coronary artery disease, the honest study. 2016. Journal of American College of Cardiology, 67(13), 1519–1527.
