What, No Toothpaste?!?

Before you have a heart attack, you can add toothpaste, just not in the way we were taught in hygiene school.  

Am I the only one that squirms when a patient asks about toothpaste ingredients?  The patient starts rambling off ingredients that you're pretty sure you recognize from hygiene school, but the recall is not there.  Thank heavens we are "able" (required) to take Continuing Education classes.  

Apparently its not only the ingredients we should be worried about but WHEN the patient brushes.  

I recently took a course from Spear Education from one of my FAVORITE hygienist-Trisha O'heir. The course was called, "The Toothpaste Secret: Helping Patients Develop Effective Toothbrushing Habits."  The course was short and it was fascinating.  She shared that in the 70's before there were strict laws on recording people without their consent,  researchers put up secret cameras to watch people brush their teeth.

As hygienist we already know what the research confirmed- patients brush sporadically-they start on the facials and barely touch the lingual side of their mouth, they don't brush very long and aren't very effective.

Her remedy was to have them brush WITHOUT toothpaste, starting on the lower right linguals for right-handed patients and lower left linguals for left-handed patients.   This is called "dry brushing."  When dry brushing is done the research shows that patients brush longer and more effectively!  

Genius!!  it makes perfect sense to have patients start brushing where they brush the least. And because toothpaste numbs senses, without toothpaste the patient can feel if his/her mouth is actually clean or not.  After the patient's mouth feels clean, advise him/her to add toothpaste and brush again. 

We still want our patients to use toothpaste but WHEN the patients uses it is very important.  

As far as patient ingredients:  O'Heir advises against any kinds of toothpaste containing microbeads. Proctor and Gamble has been working on getting the little pieces out of toothpaste but definitely look before you recommend any brand.  Also, O'Heir strongly advises against Sodium-laurel sulfate (the ingredient that causes toothpaste to foam) because of its increased risk of aphthous ulcers.  

Hygiene Edge Advice:  If you have a patient with a lot of plaque- teach them how to dry brush (we included a handout for you below).  Patients trust your opinion so be a detective and research toothpaste ingredients before you recommend a toothpaste.  

Here is a handout for you to give to your patients all about dry brushing :) 




Oral Hygiene Education Kit How To


Remember back in Dental Hygiene school and your assignment of making an oral hygiene education kit full of handouts and samples? Remember how you made it and never used it? Well, I’m going to encourage you to either pull it out or make up a new one! Especially if you temp regularly or are looking for a new job or your first job. Here are a few reasons why to brush off the dust off your old portfolio:

If you ever talk to Candi, she ALWAYS takes her OHE kit with her to temp days. I actually started to use mine again because of her! She would always get compliments from offices about how she took the time and cared for patients by bringing extra little things to give them. They definitely notice that you care for patients and aren’t there just to get through another day. She, and now I, have had several job offers from temp days by just showing we have cared about patients and their oral and overall health.

Patients notice and love stuff. When you go to a convention or an appointment, do you love getting samples? It’s human nature to love free things to try out. Your patients love it too. Giving them something physical to take home and try out will help remind them of the education you talked about during the appointment as well.

What does an OHE Kit look like?

It’s hard to stay exactly what it should look like. A system that works for you is definifely the best! I persoanlly have mine in an occordian style folder, with dividers to organize papers and producits in sections, such as Diabetes, Children, Pregnency, etc. I’ve also seen binders with page protectors to organize papers, as well as a file folder box with divided areas. Whatever you have space for or can carry is the best for you!


Now that you’re ready to remake your portofio, what should you have it in? First, look at your population that you serve. If you work in pediactrics, obviously your hand outs and products should be taylored to your little ones. If you work in a high caries risk area, make sure you have several sampeles and flyers all about decreasing caries and fluoride recommendations. Here are a few general idea you could add into your kit:

1. Xylitol Lollipops- These are my favorite to have on hand! They’re perfect to open a conversation about xylitol to parents (and have our Hygiene Edge handout to give to parents if they have any questions). They’re also amazing to have when parents bring their children to their appointment, especially when temping since a temp day is already stressful! Once they start to get wiggly, I’ll pull them out to give to the child to help them make it through the hour. I personally like the flavors of Xyloburst's lollipops.

2. Brushing/Flossing Calendars- These are always a fun motivator for both adults and children. Not many people hand them out, so talking about brushing habits and enforcing the habit with a calendar can make an impression on patients.

3. Plain Blank Index Cards- If I’m temping, I love to have some blank cards on me to make notes for the patient about OHE recommendations that we talked about during the appointment. They’re ok looking, and a lot more professional than a Post It Note. If you work at an office every week, look into having a simple paper made up with your office logo at the top. Slip this paper into the patient OHE bag to help reinforce habits at home.

4. Samples from Conventions- Floss, brushes, denture cleaner tablets, anything! It is definitely temping to use all the samples from a convention yourself (and I’m not going to lie- I use and test out most of them!) but saving them for patients is always nice. Slip them into a pocket of your OHE folder to give out to patients in practice at a later date.

5. Coupons- Again, having something tangible of a product you recommended is always great to remind the patient what exactly it was you talked about. Knowing and talking about which stores in your area that they product can be purchased at it always helpful as well.


Where to find OHE Materials to Add to your Kit

1. Colgate has some great resources for kids. These are also great to have on hand to give and chat to kids both when they’re your patient in your dental care or if they come along with their parent or grandparents appointment.

2. Listerine has some great facts sheet about how diabetes and oral health are connected. 

3. Of course, our Hygiene Edge Shop has many free downloads of hand outs for both you and your patients. Plus, we try to regularly add new ones, so keep an eye out!

4. RDH Companion is an online resource for hygienists. For a small monthly fee, you can download and print lots of OHE resources. 


Let us know how it goes! What works for you with highlighting the importance of home care? What is your favorite way to organize your OHE materials?


Spear Education: Trade the Lecture for Oral Health Coaching

Here at Hygiene Edge, we are collaborating with Spear Education for our continuing education. You can see from my screenshot below that I was watching Trish O'Hare's lecture called, "Trade the Lecture for Oral Health Coaching." 

I loved the tips she gave on how to get patients to better their oral hygiene by changing your interviewing techniques. I certainly have some work to do on asking open-ended question.

I also appreciated her words about being a coach, who wants the patient to win at their home care, versus a lecturer who can easily over-educate.

She said that we as dental professionals are oral health coaches. Which is a new label that I could get used to!


Spear Education is very interactive, as you can assign lessons to other staff members and join discussion about the topic with other dental professionals. You can take quizzes at the end of the courses that will count towards your CE's. 

How to Start a Caries Remineralization Program- Part 1

I remember as a new grad sitting there perplexed (sound familiar?) as a female patient with immaculate oral hygiene in the chair with a mouth full of caries.  She was understandably frustrated.  I tried remembering what I learned in hygiene school and couldn't come up with anything beyond brush-floss-rinse&repeat.

I even pulled the other hygienist aside and asked her what I should do.  She said "some people just have soft teeth."  I couldn't accept this.  

I went home and read and read.  I learned about the role bacteria plays in caries. I learned about a natural sweetener found in fruits, vegetables and even you body makes it- it's called xylitol.  There are over 2000 studies done and it decreases caries substantially. 

The office I worked at started a caries remineralization program with xylitol.  The kits flew off the shelf.  The only problem was- I was the only person (at the beginning) that could confidently discuss xylitol.  I want you to be able to confidently share this product with your patients.

Here is a video I made with ABC 4 in Utah discussing Xylitol.  


Coming up soon:

Part 1:  What is xylitol
Part 2:  How to explain xylitol to patients
Part 3: How to get xylitol in your office