How to Teach Your Patients To Clean Their Lower Anteriors More Effectively

I do a lot of oral hygiene education. I do it for my patients to live a healthier life, aaannnd because I'm kind of lazy, I don't want to clean as much when I see my patient in six months ;).

If a patient uses a manual tooth brush they should be dry brushing starting on the lower right linguals.  Research shows patients brush more effectively and longer. In addition to dry brushing I have my patients use many different directions on the LA- vertical, horizontal and oblique. I read an article in a hygiene magazine years ago (I can't remember the magazine) and I have been astonished how much more effective patients are at keeping the lower anterior teeth clean.

I always tell my patients that I want to "adjust" his or her technique to make him or her more effective.  I actually take the toothbrush out of the packaging and demonstrate in the patients mouth- showing the bass technique and where I want the patient to start.  After I've demonstrated, I put the tooth brush back in the packaging and in the patients bag.  

Patients have been VERY receptive and grateful, and I usually have a lot less to clean in 6 months ;) 

What to know more about how I teach this skill? Check out me educating a patient on dry brushing HERE.

Hygiene Edge Weekly Challenge:   Educate a Patient on Dry Brushing 

One Of My Best Tips For Efficient Ortho Prophys

Remember to enter our giveaway of a complete GumChucks kit HERE

Ugh. Your 30 min child prophy just showed up, right after school lunch, with a new full set of braces. This is about the time when I USED to shed a little tear as I knew I was going be be put behind in my schedule. Now when I have this scenario, I am excited for the change of routine and can complete it in the time provided. (Feel free however to schedule extra time at the next prophy visit if needed.) Here’s is the time frame ESTIMATION by minute:

• 1m-HH
• 4m-Radiographs (if needed)
• 2m-Brush the patient's teeth/OHE
• 10m-Polish, ultrasonic, hand instrumentation
• 3m-Flossing
• 5m-Exam
• 1m-Fluoride
• 4m-Dismissal/room turnaround

One of my personal biggest time savers to stay on the above schedule on an ortho patient is to disclose, hand them a mirror, and then have the patient watch me brush their teeth. This will give you a good head start on removal of materia alba and biofilm, which these patients usually have lots of, and at the same time you are doing OHE. I love a good BOGO (Brush One Get OHE). You could have the patient brush their teeth over the sink as well but I find that they take longer and still miss those hard to reach areas.

I used to hate flossing braces, as threading the floss through each time was a killer! Some time saving tips on braces are to use an ortho flosser such as the sterilizable handle from the company GumChucks with an ORTHOgami attachment, or you could use the platypus flosser or fish floss. Find one that works best for you by requesting some samples. 

Stay tuned in over the next few weeks to come as we have some videos on how to be more proficient  with the air powder polisher, ultrasonic and hand instruments on patients with ortho. 

Does Flossing Really Prevent Cavities?

I sat in a large conference room as the speaker shared that flossing is not very effective in preventing caries. Immediately, there was a tangible feeling of agitation in the air. Who does this lady think she is?  How could someone, let alone a well-known dental hygienist, say such a thing?  The speaker later shared that she has had hygienists even leave her courses over this.

Don’t we drill in our patients head brush, floss, repeat? I certainly have been guilty of being a ‘floss boss’ and telling my patients to “clean-in-between” to prevent decay.   

But, here is the thing, we say a lot of stuff in dentistry out of tradition; or because it kind of makes sense in our minds and we may not even have any research to back up. 

There was a good-sized systematic review (click here) done that showed a very weak correlation between flossing and a decrease in decay. (However, the study did show that flossing decreases gum disease). 

So how has this news changed the way I educate my patients?  If a patient has a lot of decay, and relatively healthy gingiva, I skip the floss lecture and go straight into strengthening the patient’s teeth with different products such as fluoride and eliminating known risk factors such as frequent consumption of energy drinks. 

Hygiene Edge Challenge:  Back your oral hygiene education (OHE) up with research!!

Building an Office Anti-Caries Protocol With Xylitol

I graduated hygiene school with all of the enthusiasm in the world!  I really felt like I was going to save Americans from this horrible oral health crisis. Then I started working in the real world.  I began to see patients that asked me questions that I had NO idea how to answer. I felt panicky, confused and frustrated.  I had little knowledge beyond brush, floss, and fluoride.

I remember one time in particular I had a patient with excellent oral hygiene.  She had great probe readings, little plaque and LOTS of cavities. She did not have any of the typical causes of decay (heavy soda drinking, etc.)  She was so frustrated, and I was too.   I went to another hygienist and presented her with my findings, she replied, “she must just have weak teeth.”  The patient had no trace of congenital problems with teeth formation and I couldn’t accept the idea of “it must just be the way it is for her.”

I went home and began to research everything I could from dental journals, books and hygiene message boards.  That is when I really started learning about the benefits of xylitol. There are actually over 2000 studies that have been conducted. It has the ability to drastically reduce decay (around 70 percent) and cut down plaque (50 percent,) which is more than patients usually remove by brushing.

I learned about how other countries use it in their schools but we are a little bit behind in the U.S. I also learned that when mothers had enough exposures to xylitol their babies had a huge reduction in decay because cavity-causing bacteria were not being passed.

I was so excited about xylitol and found my patients really shared my enthusiasm.  I had great compliance and saw great results. I find that hygienist are not offering xylitol to their patients because of various barriers. Below are a few solutions to those barriers. 

Lack of Knowledge:  A lot of hygienist don’t feel confident talking about a product that they don’t know a lot about.  I would recommend brushing up on the topic. I love Trisha O’heirs writing on the subject. Check out her article in dental town HERE. 

Also, a xylitol company called Xlear does lunch-in-learns over Skype. You can also check out another amazing xylitol company called Xyloburst that has an awesome website full of information.   

Here at Hygiene Edge we have also created a FREE informational handout for to give to your patients as well HERE.

Accessibility: I’ve heard from hygienists that they don’t like having to send their patients to the health food store or on online to get xylitol.  A resolution to this is do what my office does and carry the product in-office.  It was hard to keep on the shelves!  We mostly sold the Spry 30 day system from Xlear.  I’ve also personally been really impressed with Xyloburst’s selection of products; especially the suckers for kids!

Exposures:  One barrier for hygienists is that the patients have to get five exposures throughout the day.  This sounds like a lot but think of the concept of simply replacing out their existing gum/candy habit.  A lot of already snack and chew gum so simply swap it out with the products they are using.   I tell my patients to “Strive For Five”!

Expense:  The beauty of having xylitol in your office is that you can lower the price a little bit.  Xylitol is definitely more expensive than gum with sorbitol and other sugars but it’s a LOT cheaper than a cavity and precious tooth structure.  I always let my patients decide and most are willing and grateful to try something “new.”

It will take some work but you too can create an anti-cavity protocol for your office that will benefit your patients long term. 

Oral Hygiene Education Week- When Does OHE Start?

One of the questions that often gets brought up is when oral hygiene education should be started. Should it begin after the probe depths are recorded, after the diagnosis has been made, or after the prophy appointment is almost complete?

Our answer to this question is:

OHE starts in the waiting room!

What does this mean? From the very first second that you meet your patient, OHE has technically started. The patient determines from the first few minutes of meeting you if you are trustworthy and educated, or if you are just there to "polish" their teeth. This first few introduction minutes are critical to gain credibility with the patient. So make those minutes count! Make sure you are wearing clean scrubs, clean shoes, and your hair is off your face. Make sure jewelry minimal. And make sure you are wearing a white lab jacket! We'll talk more about lab jackets this week, but they can make a huge impression on patients. Second, no cattle calling in the waiting room. Treat the patient like a person. If you have never met a patient before, look up their photo or their birthday so you know generally who you will be looking for in the waiting room. Approach them, smile, and shake their hand. Direct them back to your operatory instead of running away from them and hoping they follow you along.

These little steps will help your oral hygiene education and will show your patient that what you are educating them on will help their health.

Do YOU have a favorite method of bringing patients from the waiting room to the op? Let us know below!

Stay tuned for more OHE tips throughout the week!

Oral Hygiene Education Week

We loved being able to talk to Hygienists at our Continuing Education course last week. We loved it so much, we wanted to share it every dental hygienist. For the next week, we'll be posting little tips and tricks to help your oral hygiene education practice in your offices. And to kick off the week, why not start with a giveaway? We'll be giving away 3 of the sample packs that were given away at the meeting!

Packet includes: 1 Orabrush, 1 package of Xyloburst mints, Xyloburst lollipops, Xyloburst gum samples, Closys sample package, and 1 Xyloburst oral rinse.

To enter, tell us in the comments below your favorite Oral Hygiene Education analogy you tell your patients, or your favorite product to recommend. 

Don't forget to check each day for new tips to improve your OHE!