To stain ... or not to stain

Disclosing solution is messy, but it`s consistent and effective. Here`s how the author utilizes the solution while eliminating the mess.

Jul 1st, 1999

Disclosing solution is messy, but it`s consistent and effective. Here`s how the author utilizes the solution while eliminating the mess.

Janet R. Hagerman, RDH, BS

I can think of plenty of reasons not to use disclosing solution. It can stain and ruin my uniforms, my patient`s clothes, my expensive operatory furniture, my sink, and my countertop. The stuff is just plain messy. I`ve tried it with kids who have not yet learned to swish - total disaster!

So, why am I committed to using disclosing solution on almost all of my patients? It works. It`s consistent and effective. It provides a whole new level of communication by providing what I cannot as a health instructor - a totally unbiased report of my patient`s plaque level. There is a big difference between me telling patients they have this invisible plaque on their teeth, and patients seeing the plaque on their teeth come to bright life in living red color. It also helps me to define their problem areas so we can focus on them together.

I have such great success with disclosing solution that I have, over the years, developed staining techniques that best utilize the solution while eliminating the mess. Here they are:

* Dilute the dye slightly with water. I give my patients a cup containing a small amount of slightly diluted solution (50-50, 10 drips dye) and ask them to rinse carefully and spit it back into the cup. I always give them a paper towel to use as a napkin, which I immediately offer to dispose of when they finish using it. So far, the patient still is in the sitting position.

* Tour the mouth together. As I lower the chair, I explain that the solution helps identify any areas of plaque. I avoid negative and demeaning phrases like "problem areas" or "to help you brush better." Before I look into their mouths, I give patients a hand mirror as I say, "We`re going to take a tour of your mouth together."

* Praise first. Remember when your mom taught you to compliment before you criticize? She was right. I always find areas to compliment. I praise anything that is white. Then, I go on to identify areas of plaque "so we can refine your technique." Typically these areas will be posterior, along the cemento enamel junction, and interproximally. These areas are the perfect lead in to instruction of sulcular brushing and flossing technique.

* Urge caution with home use. I regularly dispense disclosing tablets to my patients for home use. I explain how to use them without making a mess. Tell them it is a dye, so be careful.

* Kids can`t swish! Have you noticed how funny they look? I`ve seen kids keep their mouth still and shake their head. If a kid`s mouth is full of disclosing solution and his or her mouth is not shut tight, watch out! Instead of swishing, I swab a kid`s teeth with a cotton swab soaked in undiluted stain and rinse slightly. Then I show the results to mom and/or the child.

* Other special patients. Sometimes patients who are disabled or geriatric may not be good candidates for staining. Don`t go there. If you feel that they can benefit from hygiene instruction and staining, proceed cautiously. You may find the swab method more effective.

I use disclosing stain with all new patients, all soft-tissue-management patients, and all recare patients until they become plaque-free with no bleeding. I used to think of disclosing as an inconvenient extra procedure. Now that I have developed these techniques, it`s easy and fun. It takes the pressure off of me. I`m not the one pointing the finger. The dye says it all for me. Some of my patients actually like it. They want to see their results and look for their improvement. It feels great to say, "Wow! You`re practically plaque-free. What an improvement. You`re doing great!" What a way to start the day!

Janet Hagerman, RDH, BS, is a clinical dental hygienist, author, and speaker residing in Atlanta, Ga. She can be contacted at (404) 255-1135.

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