From Plaque to Pedagogy

Oct. 1, 2003
While undergoing a career change into teaching, a school teacher reflects on some wonderful lessons dental hygiene taught her.

by Nancy Barnhart, RDH

When a career change leads into teaching, the person making the change brings skills from the former career. The ex-chef brings cooking into the curriculum. The ex-designer brings the "how-to" of decorating the bulletin board attractively. My first career was dental hygiene. What would I bring?

The more I learned about educating children, the more I realized that much of what I did to meet the needs of children as a dental hygienist was similar to what I would do to meet the needs of students in a classroom. During my first career, as the years progressed, my satisfaction was no longer defined by how proficiently I scaled plaque off of teeth. It was defined by how effectively I could guide a child through a successful dental visit.

There were successful outcomes. A proud and delighted, yet somewhat surprised, smile beamed across the face of the three-year-old child with thick black curls. She hopped down from the bench, ran with outstretched arms toward her mother and blurted with excitement, "Mommy, I did it! It was easy and fun. When do I get to come back?"

There were touching moments. Parents, with a previous history of unpleasant dental experiences, approached me with tears in their eyes and expressed gratitude for creating a comfortable and safe environment for their child. It was then I knew I had broken the vicious cycle of "dental fears" among families.

I was making a difference in the oral health care of the children I saw in the dental office. Now, I wanted something more than just a healthy mouth. I strived for a healthy mind and body as well.

There are many similarities between my first and second careers. Both careers need practitioners who really understand child growth and development. Both require patience and understanding.

One goal in both the dental office and the classroom is to create a safe and comfortable environment where children feel a sense of belonging. Alleviating dental fears in young patients helps them feel safe. Sometimes, it was as easy as showing a child that the visit would be pleasant by allowing the child to touch, taste, feel, and see what I would be introducing into his or her mouth. Often, it involved transitioning a child from having a parent at his or her side to the child taking my hand and entering the operatory all by themselves.

A safe environment includes trust. Educators establish trust with students. Students must trust the teacher and the classroom environment in order to take risks to grow and learn. Dental patients must trust and feel comfortable with the practitioners who work in such close proximity to them.

Both the dental office and classroom provide opportunities for children to assume responsibility for their own learning. In the dental office, our goal was to educate, not intimidate or embarrass patients into compliance. Education helped my young patients realize they had the power to have a healthy mouth; it depended on their actions and decisions. Similarly, students in the classroom enhance their learning when they assume responsibility for their own learning.

Educators and dental professionals alike understand the milestones in a child's life. The significant events of losing that first tooth, as well as the feeling of devastation of being the last kid in your class to lose a tooth, serve as examples — not to mention the six-year-old child who feels "grown up" after discovering he or she mysteriously grew six-year "adult" molars behind all of his or her baby teeth. A milestone truly worth celebrating!

Younger patients anticipate getting braces, thus, raising their status with their peers. This elevated status is short-lived as they realize having braces is not as "cool" as they thought it might be. Braces are work! They require extra care. Even the enticement of choosing from the rainbow assortment of colored rubber bands wears off quickly.

The gangly teenager, not yet accustomed to a changing body, is suddenly faced with the horrors of acquiring "tinsel teeth." Becoming a "metal mouth" will ruin his or her budding good looks just when the opposite sex is starting to notice. How traumatic! Before actually getting braces, the teenager starts counting the days until he or she gets them off.

Hands-on activities

Both dental hygienists and teachers get the best results when they actively involve children in what they are doing. Educators understand the importance of dramatic play, giving students choices, and allowing students to investigate and explore. All of these elements ensure success in the dental office and the classroom.

On their first exam, young patients helped with their own exams by holding a mirror just like the dentist. Initially, they practiced using their mirrors to look into an animal puppet's mouth just as the dentist would examine the child's mouth. Then, we would use the dental explorer to count Mom's fingers and then the child's. We'd ask them to guess (predict) how many teeth they had in their mouth and then would confirm that number by counting them. Kids were amazed to learn that if they counted all their fingers and all their toes the result equals the number of baby teeth they had in their mouth. Of course, this revelation is only magical for those five years of age and under. Before we polished their teeth, children had the opportunity to feel the "tickle toothbrush" on their fingernail before we touched it to their teeth.

Often, we gave kids facial masks, gloves, and disposable mouth mirrors so that they could play dentist at home. They instantly wanted to play dress-up. Imagine the sight ... a facial mask so large it nearly covered their little faces. Their eyelashes would blink the mask off their eyes long enough for them to see where they were walking. Their little arms would be poised at right angles in the air as if scrubbed and ready for surgery. Their entire hand fit into the palm of the latex glove, usually with room left over. The fingers of the latex gloves wobbled in the air as the child tightly grasped the dental mirror. They were ready to play dentist.

Children always had choices in the dental office. They selected their own flavor of polishing paste, even if that meant mixing the favorite toothpaste they used at home with my toothpaste. They had the choice of flavors in fluoride also. We had the standard favorites, but we always tried to keep it interesting by introducing a variety of flavors. Bubblegum was, by far, the favorite. We coined our office "The Baskin Robbins" of toothpaste.

Each child chose the color of the new toothbrush he or she would take home. They even had a choice in the flavor of dental floss, although bubblegum was the most popular, even with adults.

We would introduce X-rays by allowing children to hold an X-ray and take it apart or practice placing it in their own mouths. After their X-rays were taken, they would accompany me into the darkroom and help develop the films. After the films were developed, we showed them the erupted teeth and tooth buds growing. This was a field trip in itself.

Running records

My experience with dental running records and rules from my first career prepared me for my second career. In the classroom, running records and classroom rules begin on day one. Teachers record daily observations of students' strengths/weaknesses in order to meet individual needs. Teacher-generated and student-generated posters and lists of rules ("How we treat each other in this classroom") are displayed in the classroom.

In the dental office, I meticulously recorded each child's oral hygiene each time he or she came for an appointment. I felt tremendous pride in my patients when they returned for their semiannual appointment and noticed significant improvement in their oral health care. We celebrated with high-fives, positive reinforcement, or trinkets reserved for "special occasions" (not the regular prizes we heaped into the treasure box).

Each dental visit was tailored to match my patient's needs, as long as the modifications remained under OSHA standards and my safety standards of "freedom within limits." I always took the time to explain the rules and more importantly why we had rules. I recorded the modifications on each child's chart so I would be prepared for his or her next visit. This ensured that we were meeting the needs of each child.

Parents as partners

Perhaps the most valuable background experience that anyone from any "first career" can bring into teaching is experience with parents. Parental support in the classroom cannot be overly emphasized. Sometimes, explaining and reassuring parents regarding their child's educational strides is necessary.

As a dental hygienist, I had a conference with every parent after each visit to discuss the positive aspects of the visit, areas to improve on, or progress made by their child.

Often, the conference included easing a parent's mind. Understanding child development helped me explain the spectrum of their child's mixed dentition, and whether their child was early/late within that growth spectrum. Alarmed parents frantically wanted to know why their eight-year-old grew such large adult teeth. We calmly reassured the parents that, indeed, their eight-year-old child would "grow into" his or her teeth.

Or, the six-year-old whose two front lower adult teeth decided to erupt behind the two baby teeth stubbornly still in place. The result resembles a shark — two rows of teeth. This required reassurance and explaining to parents that the adult teeth will resume a normal position after the baby teeth are removed.

Sometimes, we had to gently convince parents that it is better for their child to have extra space between their baby teeth, rather than having a closely aligned row of baby teeth. The extra room provides more space in the mouth for adult teeth to erupt.

We did everything we could in the dental office to provide a comfortable environment for children. Was it time consuming? Yes. Was it a constant source of irritation for the assistants? Most definitely. Was it successful? Absolutely.

The result? To the best of my ability, each child had his or her own unique positive dental experience — one in which he or she had choices, assumed control and responsibility over his or her own oral health. Each child had a dental visit tailored to his or her individual needs. I hope I may be as successful in my teaching profession.

Author's note: As a tribute to my profession, I reflect on the successes and touching moments dental hygiene has provided me, as I leave my first profession and prepare to enter my second career. This article, while light-hearted, reflects the satisfactions I received and the gifts I brought to my profession and to my patients.

Nancy Barnhart, RDH, resides in Morgan's Point, Texas. She can be contacted at [email protected].