Preventive dental hygiene: 4 tips for disrupting disease and upping prevention in your appointments


There is a lot of discussion about non-invasive or minimally invasive dentistry. Products like Silver Diamine Fluoride or Curodont Repair offer treatment options that don't require a drill, allowing doctors to stop decay without simply placing a “watch” on it and waiting for the disease to progress. What if we had the same thought process when it comes to dental hygiene?

Of course, most of the treatments we offer are minimally invasive, but are we really intervening in the early stages? Do we need to perform laser focus when there are multiple bleeding points or there is a tendency for tooth decay? Or do we give the same brush and floss lecture, hand them gift bags, and send them off to the front – only to repeat the same thing over the course of a few months?

What if we could prevent disease more often rather than just treat it? With few exceptions, most oral diseases can be prevented through early intervention. Many clinicians feel limited by factors such as time constraints, insurance, office policies, and patient support. We could spend an hour educating instead of buying a scaler, but what would we charge?

How can we hygienists make the most of the precious time we have with our patients and help them understand the value of prevention? These four concepts are familiar and easy to implement into your sanitation process. When patients understand their condition, they can reverse or prevent early-stage disease.

Amanda Hill also wrote: Lead X-ray shielding: a thing of the past?

Nipple Bleeding Index (PBI)

PBI is my new favorite and a proven way to help patients understand that their gums are indeed bleeding and that this is a problem. I learned about PBI at a conference where OraVital owner James Hyland, DDS, BSc, spoke. After updating the medical history, vital signs, and oral cancer and airway screening, hand the patient a soft pick or a small interproximal brush and ask them to insert it between the teeth. Have them see the bleeding spots in a mirror and note the number of spots. You're no longer the one making them bleed with a pointing tool; they can see they have inflammation.

Public solution

It's time to go back to old school and get some public solutions. I often hear hygienists advise against using this. They were either triggered because it was used to lower their grades in health school, or they were worried about the chaos it would cause. Like anything, you get better with practice. If you are used to applying it to your patient's lips, start with Vaseline. Retractors are also a great tool for keeping your lips away from solution.

Using publicly available solutions is a great teaching tool. When using it, let the patient know how it works. Depending on the brand, it may stain the plaque different colors depending on its age. New plaque is one color, plaque older than 48 hours is another color, and some even show a different color of acidic plaque. Gone is their excuse that they didn’t have time to brush their teeth after lunch. After applying, have the patient sit up, give them a mirror, and stop talking. Let them discover where they are lacking, then ask if they need some tips on how to get to those areas. We often assume patients know how to brush their teeth, but they may need some help. In my experience, patients come to their next appointment determined to see less color!

Loud detection

Speaking out loud about exploring the depths is not a new concept. It's simple and effective, but often skipped on crowded dates. The technology of recording detection tools is improving every day. If you're lucky enough to have one, use it. If it confuses you, get trained. I see so many things gathering dust on the counters. Even if you're typing the numbers back and forth on your keyboard yourself, say them out loud. That way, when you sit the patient down to discuss your findings, they can make a diagnosis. This doesn't look like it came out of nowhere.

Interdental cleaning beyond flossing

I chose the term “interdental cleaning” intentionally. Hygienists get a bad rap for our flossing lectures. For some reason, we're convinced that flossing is the golden ticket to oral health. While I’m not disparaging flossing, there are other ways to clean between teeth, and it’s time we embrace them and help our patients succeed. How are they going to deal with these bleeding points when the biofilm is busy replicating between the teeth and they don't have the right C-shaped curve?

Comfort recommends interdental brushing, water flossing, and hydrogen peroxide gel tray therapy. Many companies that make these products offer lunch and learns and provide you with samples or professional pricing.



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