Th Readers Forum 01

Readers’ Forum

Sept. 1, 2008
I read with interest the Reader’s Forum in the June, 2008 issue and one letter in particular drew my attention.

Dear RDH:

I read with interest the Reader’s Forum in the June, 2008 issue and one letter in particular drew my attention. The note contained the sentiment that some hygienists are being made to feel that they are “… less of a hygienist if [they] do not wish to become an expanded function hygienist.” As ADHA president, this idea concerns me.

With the push for the creation of the Advanced Dental Hygiene Practitioner (ADHP), ADHA has put a lot of time and effort into promoting this new model as a way to ease the access to care crisis which this country currently faces. But in no way was the intent of ADHA to diminish the role or the value of the existing models of dental hygiene.

Practicing clinicians who “go to work, teach prevention, educate patients, and, yes, clean teeth” are, and always will be, the backbone of the dental hygiene profession and ADHA. Without their continued efforts and support, no advancement within the profession would be even remotely possible. ADHA will always be forever grateful to hygienists who are passionate about their profession and who love what they do.

The ADHP may not be the choice for every hygienist; it was designed as another career path for hygienists who choose to explore it, adding to an already impressive array of professional options from which all hygienists have to choose. As your professional association, we’re delighted to read that despite some of these concerns, your enthusiasm remains for areas such as the ADHP — and we hope to impress upon each of our members and potential members that no matter your career path as a hygienist, that being a hygienist is all that matters and we are here for you.

Thank you for all that you do. Thank you for your passion and enthusiasm. And thank you for your continued support of your profession, and your association.

Diann Bomkamp, RDH, BSDH
ADHA President

Dear RDH:

I want to thank PennWell for the wonderful experience of RDH Under One Roof (UOR). These are such exciting times to be a dental hygienist. In the 35 years that I have been a hygienist, the public knowledge and perception has elevated greatly in regards to the importance of optimum dental health. As health-care professionals, we are receiving the recognition we deserve for our impact to the general health of patients as well. This is what makes me so proud to be a dental hygienist.


RDH magazine publishes many articles written by dental hygiene professionals. Author statements are not always followed up with citations, and these statements may reflect only the sole opinion of the author. In a recent article titled, “Minimal Intervention: Toothpaste and Other Mysteries” (July 2008, page 68), a dental hygienist commented on triclosan, which is incorporated in Colgate Total toothpaste. For clarification: Colgate Total toothpaste is one of the most extensively tested and reviewed toothpastes in the world. Its safety and effectiveness have been approved by the world’s leading health regulatory agencies, including the U.S. Food and Drug Administration and the United Kingdom Medicines and Healthcare Regulatory Authorities.

For many years I took continuing education and did not receive credits, because at that time mandatory CE was not required in the state of Maryland. Though CE was not a requirement, learning and my professionalism was very important.

During the time spent at UOR, I was dismayed to see so many hygienists attend courses in attire that does not meet that professional standard. I feel that business/professional attire does not include jeans, T-shirts, shorts, hot pants, revealing bust lines, and flip-flops.

In order for our profession to move in the direction which gives us more credibility and respect, it is very important that hygienists look professional while attending dental programs. I strongly believe the dental hygienist will be the most influential health-care provider of the future. How we present ourselves to the public will help to ensure this.

In closing, I had the privilege to meet and spend time with Dr. Esther Wilkins. Without her input to our education, none of us would be dental hygienists. She is an inspiration to all of us. Thank you, Dr. Wilkins.

I look forward to the next UOR.
Sandy Sheffler, RDH
Baltimore, Maryland

A Moment in Dental Science
The Hidden Threat, the Thyroid Gland*

Thyroid disorders are not always obvious since many symptoms of an underactive thyroid or hypothyroidism, such as weight gain and fatigue, are nonspecific and may be attributed to aging, menopause, or depression. And symptoms of hyperthyroidism, like nervousness, insomnia, and heart palpitations, may be attributed to anxiety. Consequently, thyroid disease is grossly underdiagnosed. Things get even more serious when considering cancer of the gland.

The gland is located in anterior and lateral regions of the neck, inferior to thyroid cartilage, at the junction between the larynx and trachea. It produces thyroxine, secreted directly into the blood, stimulating metabolic rate. It consists of two lateral lobes, right and left, connected anteriorly by isthmus.

Click here to enlarge image

Examination is carried out by locating the thyroid cartilage and passing the fingers inferolaterally, examining for abnormal masses or overall thyroid size. Then place one hand on each of the trachea, gently displacing the thyroid tissue to the other side of the neck while the other hand manually palpates the displaced gland tissue. Then the two lobes of the gland should be compared using visual inspection and a combination of bimanual or manual palpation. Finally, ask the patient to swallow to check for mobility of the gland. Many clinicians find that having the patient swallow water helps the examination for mobility, as well as having the patient flex the neck slightly to the side when being palpated.

The thyroid may become enlarged during disease process, producing a goiter. Thus, it may be firmer and tender when palpated and may contain hard masses. It may also lose its mobility and not move up when the patient swallows, indicating a tumorous growth. The patient should be referred to a physician if there are any undiagnosed changes in the gland or past radiation history.


  • Recent research reported that taking the same dose of levothyroxine (i.e., Synthroid) at bedtime, as compared to first thing in the morning, might be better.
  • Ultrasound can be for imaging thyroid nodules or masses instead of X-rays, treatment with intensity modulated radiotherapy, and use of new molecular regulators of hyperthyroidism and goiter.

* From Review of Dental Hygiene, 2nd edition, Saunders/Elsevier, 2009 (Fehrenbach, Weiner), available Dec. 2008.