By Anne Nugent Guignon
Catalog shopping has been a big business for many years. Before the advent of slick, upscale specialty catalogs, stores such as Sears, JCPenney, and Montgomery Ward issued thick books to households all over the country. These all-purpose catalogs advertised everything from underwear to pots and pans to the latest appliance that was guaranteed to streamline modern lives.
The Christmas catalog was the most important one that came to our house when I was little. Our excitement would build to a frenzied pitch from Thanksgiving to the end of the holiday season. We would spend hours fantasizing about the perfect gifts ... ones that we could either give or receive. We were never sure if the adults in charge of the purchasing understood all of our transparent hints.
Wouldn't it be neat if we had a special catalog that hygienists could peruse and order from 365 days a year? My imaginary dental hygiene catalog is divided into two sections. The first section includes items and supplies that dental hygienists want and need as clinical professionals. The second section would focus on those that we care for 365 days a year — the patients that look to us for expert preventive and therapeutic care.
Can you picture how amazing the world would be if we adopted a holiday spirit 365 days a year? If this feels like a daunting task, then just break down this idea into more manageable component parts.
For example, if you have patients that suffer from Sjogren's syndrome or any other condition — such as chemotherapy — that results in non-stop, day-in and day-out xerostomia, wouldn't you like to have a special dental hygiene catalog that would help you find things that could help improve their quality of life? If you review all of the symptoms and clinical manifestations of patients who suffer from dry mouth, you know that these patients are desperate for moisture. Their mouths taste bad, and any alcohol products or those with a lot of flavorings are ill advised. A growing number of patients need or request alcohol-free products. These include those that are suffering from dry mouth problems as well as those recovering from alcohol dependency.
Xerostomia patients need special products. If we can help these patients have a more normal oral environment, then the resulting periodontal disease and caries can be kept at bay for a longer period. Laclede makes Biotène products which are alcohol free and specially formulated to restore oral moisture, as well as provide the natural enzyme balance found in a healthy mouth
Have you ever considered getting samples of these products for your patients to try? On the other hand, how about having some Biotène patient care packs, which contain small sizes of both the Oral Balance gel and Biotène paste and mouthrinse, giving these packs to patients or their loved ones? The cost to the practice is minimal, and the patient comfort benefits are far reaching. A special gift like this show them how much you really care about oral health and comfort.
Rembrandt products also offer many patients relief. Several types of Rembrandt toothpaste are free of sodium laurel sulfate (SLS) and pyrophosphates. Why is this important? A certain segment of the population is sensitive to SLS, the foaming agent in pastes and rinses. Other people have soft tissue reactions to tartar control pastes that use pyrophosphates. These unfortunate patients suffer from outbreaks of recurrent apthous ulcers (RAU), tissue sloughing, and tooth sensitivity.
In addition, all Rembrandt mouthrinses are alcoholfree and several do not contain either SLS or pyrophosphates. It is important to check the labels for any products that you recommend.
If you have never had an apthous ulcer, then you are lucky. If you have experienced one, then you know that this little area of ulcerated tissue can consume your entire focus during waking hours. The majority of patients that use Rembrandt Canker Sore toothpaste experience a lower incidence of ulcerations, as well as a reduction in discomfort. Biotène Oral Balance gel, which is also free of SLS and pyrophosphates, can also reduce the healing time for apthous ulcers. Imagine if you could help just one patient with this common perplexing problem. He or she would be your patient for life.
Sensitive teeth are a very complicated issue. Sometimes it is hard to determine if the etiology is caries, root exposure, periodontal disease, dietary habits, eating disorders, or bruxism. There are multiple reasons for why patients have sensitive teeth, and patients often confuse sensitive teeth with sensitive soft tissue. We are charged with being super detectives. Once you have recorded all of the pertinent data regarding their teeth and gums, have you ever considered trying various types of desensitizers to help narrow down the cause?
For example, if teeth are desensitized at the dental chair with products like ProClude desensitizing prophy paste, Colgate Dentin Bloc, Heraus Kulzer Gluma, or one of the fluoride tooth varnishes, then most likely you have treated a case of dentinal hypersensitivity. Cases like these can be followed up with any of the following: Prescription fluoride gels or pastes; an over-the-counter desensitizing toothpaste, or Ortek's new FDA approved DenClude paste, which should be available right after the first of the year.
Patients who experience relief from dentinal hypersensitivity are extremely grateful. If they do not get relief, then you and your doctor can consider the desensitizing treatment as a differential diagnosis. The real bonus is that you acknowledged their discomfort and searched for a way to alleviate it. You have paid attention to a very real problem and tried to help resolve it. You did not dismiss their situation with a trite remark such as, "I know how you feel, so I'll hurry up and get through the prophy." I have never met a hypochondriac dental patient. Who would want to make up stories about dental pain?
How about the patient who cannot tolerate any flavors or colors in the products we use? Prophy paste is the perfect example. The flavorings just do not appeal to certain people. Other patients are concerned about allergies or sensitivities to flavorings or other additives. Patients who suffer from celiac disease cannot tolerate gluten. According to prophy paste manufacturers, some flavors and colors may contain gluten, but it is impossible to determine which do because information about these additives may be proprietary.
So, if these patients wanted their teeth polished, most of us thought our only choice was pumice and water. This basic concoction is messy and does not have the smooth consistency found in regular prophy paste. Did you know that two companies make a prophy paste without additives? Denticator's Sure Clean and Preventech's NADA are two products that are perfect for situations like this.
Dental practices vary widely in philosophy and temperament. Some go out of their way to have samples or products available for their patients. Others view this as product endorsement or selling. While I find the latter to be a old-fashioned point of view, especially in light of patient comfort issues, one must feel comfortable about the products that you are recommending.
Consider the issue from a different point of view. If you asked your physician to recommend a product to treat athlete's foot or warts, wouldn't you be perplexed if they could not or would not offer a recommendation? We are the oral health care experts. Patients ask for our advice and they expect us to have some answers or solutions. If your practice doesn't want to dispense products, how about some alternatives? Take a stroll down the aisles of your local drug store and see what is on the shelves. If you don't see the products that you recommend, then consider having a chat with the pharmacist. Even if the store has a product such as Oral Balance, it might be hidden behind the counter rather than being plainly displayed.
Patients can also be directed to the Internet. For example, Rembrandt products can be purchased directly from the company. Laclede has a long list of stores where patients can purchase Biotène products directly on line.
All of these issues are quality of life issues. So what about the person whose life has taken a turn away from the mainstream? I'm talking about the panhandler on the corner of a busy intersection, the woman who had the courage to leave an abusive relationship and head for a shelter, or the elder parked in the hallway of a long-term care facility?
What can we do for these folks? Even if they are not our patients, they are still human beings. Be creative. You have 365 days a year to make their day better. Delight in the opportunity to share your goodness throughout the year. Remember to be patient. Remember to be sincere and remember to smile. Donate to a food bank or spend a few hours helping there or at a shelter. Give a street person a few dollars (If cash bothers you, give a food voucher for a local restaurant). Package soap and shampoo samples for a shelter. Add a brush and paste.
Our comfort zone catalog is available all year long. Be glad that there are so many opportunities for us to be the professionals who can make a difference in so many lives 365 days a year.
Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].