Biofilm Reduction with Hybenex
Do you remember in dental hygiene school when bacteria and biofilm was explained? Back when I was in dental hygiene school, it was just switching from being called plaque to biofilm, which with research showed that the bacteria found in the oral cavity was more complicated than originally thought. This complex matrix that bacteria forms is a key part in managing infection anywhere, but definitely in the mouth. Now, years after I have graduated, there has been so much research on biofilm, what it is, and how it reacts to the space around it in the oral cavity. And with that research has come better ways on managing it.
Why is managing biofilm and the bacterial load so important? We know that the bacterial load in the mouth refers to the number and types of bacteria present in the oral cavity at any given time. The mouth is home to a diverse community of microorganisms, including bacteria, viruses, and fungi. The bacterial load in the mouth can vary depending on a variety of factors, such as diet, oral hygiene practices, and overall health. When this load becomes unbalanced, these harmful bacteria can cause infection or decay in your patients, especially in patients who are immunocompromised or fighting bacteria somewhere else in their body.
One product that I’ve been using the last few months and am sold on is HYBENX. With numerous supporting research, and now my anecdotal research, this product helps decrease biofilm and in turn decrease inflammation in any patient that presents with biofilm (and let’s be honest- isn’t that everyone?!). It’s easy to use, comes in easy to use liquid or gel, and is easy to see when applied due to the color. If you’ve been searching for something new to help mitigate biofilm in your patients, you’ll definitely want to check out this product.
To learn more about the application process, check out our latest video:
xoxo, Melia
Interested in learning more, and how you can incorporate HYBENX into your practice, check out there website. Thank you to EPIEN Medical, Inc for supporting dental hygienists around the globe, and for supporting us at Hygiene Edge.
Typdonts with Acadental
When I think of typodonts, it always takes me back to when I was a dental hygiene student. My first day of school, we took a tour of the school and clinic, just to get familiarized with the area and where we will spend the next 2 years. I remember walking into the lab and on the wall was a row of heads and teeth. Yikes! Then, when it was finally time to pull them out and practice in clinic, they turned from a bit scary to a bit annoying. The gingiva was so firm and bulky, the mouth wouldn’t stay open, and they were awkward to work around.
Thank heaven they’ve come a long way since that 1st day of dental hygiene school more than a decade ago. Now, so much more research and development have gone into them to help simulate a real patient experience. Just like this Acadental typodont.
To learn about it, what it can do, and how it can help both in school and in practice, check it out in our latest video below.
https://www.youtube.com/watch?v=0BezLi3HxOY
When you see a typodont, what do you think of?
Thank you to Acadental for supporting us at Hygiene Edge! To learn more, check out adadental.com.
xoxo, Melia
Aphthous Ulcers: A Deeper Dive
Author Sarah Bateman
Minor Aphthous Ulcer Photo source Hygiene Edge
Idiopathic is a term that may come to mind when we think of an aphthous ulcer as they seem to arise with no rhyme or reason. Our patients often ask us how to avoid getting them altogether and we are often left wishing there was something we could suggest for prevention. Yet, in the end we tell our patient something like, “I am sorry, I wish I had the secret to make it so you no longer get them.” While there may not be anything we can do to prevent them, we should ask ourselves if there could be an underlying systemic cause of the lesion. For example, there is evidence that links aphthous-like ulcers to other chronic diseases like Crohn’s Disease.
Minor Aphthous Ulcer Photo source Hygiene Edge
Have you ever had a patient that had an unusually large aphthous ulcer; possibly twice the size (> 1 cm in diameter) compared to the minor aphthous ulcer ( < 1cm) in image below? If so then this is categorized as a major aphthous ulcer. 1
One time I had a patient in my chair with a major aphthous ulcer on the palette that was about 1cm in diameter. I had recently been learning about aphthous ulcers in correlation to Irritable Bowel Disease (IBD), and more specifically Crohn’s Disease (CD). I asked the patient, who had not indicated anything regarding IBD on her health history, if she had ever had any issues with IBD. She told me she had been seeing doctors for the possibility of CD and she was shocked I even asked.
So the next time you see one or have a patient that gets them frequently ask yourself, does their health history indicate IBD or more specifically CD? If your patient does have CD, ask if they have any ulcers or other oral manifestations in their mouth during flare-ups.
An article from the Journal of Colitis and Crohn’s stated, “Oral manifestations such as oral aphthous ulcers are frequently associated with active disease and improve with the resolution of intestinal inflammation. Although oral manifestations can occur in both forms of IBD, it is more common in CD, with almost 50% of subjects reporting oral manifestations.” 2 Even though prevention of these lesions is not a current possibility, the ability to link them to a flare up of CD, can help a patient understand why they may be experiencing them.
Sarah Bateman, MEd, BSDH, RDH
Sources:
1. Amin, S., & All, R. (2018, October 3). Crohn's mouth ulcers: Symptoms, causes, and treatments. Medical News Today. Retrieved April 25, 2023, from https://www.medicalnewstoday.com/articles/323244
2. Hu, S., Mok, J., Gowans, M., Ong, D. E. H., Hartono, J. L., & Lee, J. W. J. (2022, May 2). Oral Microbiome of Crohn's Disease Patients With and Without Oral Manifestations. Academic.oup.com. Retrieved April 25, 2023, from https://academic.oup.com/ecco-jcc/article/16/10/1628/6577053
Note: Consent was given to use images.
Sarah has been a dental hygienist for eleven years and has been in the dental field for 17 years. She lives on a ranch with her husband and their little boy who is almost a year old! Sarah has worked private practice and was a clinical instructor and professor at the Utah College of Dental Hygiene for 8 years before she had her baby and moved to their dream ranch in Idaho! She still temps in private practice two times a month right now while enjoying baby cuddles!
Stuck in the Hygiene Rut?!
I found myself two years into my hygiene career not loving it. Have you been there? Are you there right now?! You are not alone! For me, I was working 5-6 days a week, long hours, no assistant with double or accelerated hygiene. I would get asked to work through lunch or stay an hour late to accommodate a new patient. I was new to the hygiene world and the market for hygiene was so different! There were not a lot of hygiene opportunities and I felt as if there was not another option other than sticking it out, proving myself and just pushing through. Heck, I had made it through dental hygiene school, so I knew I could do hard things. I was in the career I had spent year working hard towards and I was not feeling fulfilled. My body was in pain, I didn’t have any energy to do anything after work like work out or do much other than go home, sit on the couch, and just get ready to go to sleep, wake up and do it all again. I had vented to my mom on the phone and one day she had just spoken to her hygienist and that hygienist had given my mom some advice to pass along and that advice changed everything for me! Disclaimer: that this did not happen all at once. But the pieces of advice I slowly implemented, and I truly feel it changed me into a different hygienist and person all around.
The first thing she said was, “Yes- what your daughter is going through what a lot of hygienists go through. That is normal but she needs to get involved!” The first way she recommended getting involved was going to continuing education courses and try to constantly take as many courses as she can. Continuing education courses not only help us keep our licensure and keep up us to date but kind of refresh us as hygienists and motivate us to be better. I come out of most CE courses ready and excited to implement what I have learned; it helps with the monotony of 1-hour patients back-to-back to back, right?! I also recommend that you take classes throughout your renewal period so that you are consistently feeling refreshed with new information or new motivations/tips and tricks to try. You can learn about so many new products to try as well.
The second thing she recommended was getting involved with my own body. She recommended taking time to do yoga for my body. Now, I have tried yoga and I am not great at it but stretching and breath work is so beneficial for not only our bodies but our minds. I have also implemented strength training into my work-out regiments and that has helped my back and neck tremendously. Strengthening my core has made a huge different in the pain I used to have in my back. A quick side story to combine these first two ways of getting involved. I was at an in person continuing education course and met a hygienist who had been a hygienist for 42 years. She was vibrant and so healthy and fit. I asked her what her secret was, and it was YOGA!
The third thing she said was “to get involved in changing my frame of mind”. I asked my mom what that meant, and my mom responded, “I don’t know what exactly she meant but that was the last thing she told me.” So, I have now had a few years to ponder that and here is what I have come up with. First, I had been in this mindset of oh my 2:00 o’clock patient didn’t show…. Do you see what I was doing there?? I wasn’t thinking of my patient as a patient I was thinking of the patient as a one-hour block of time to hurdle through before the next hour block of time etc., until I got to go home. Later I found out that the 2:00 o’clock patient had been in a car accident on her way to our office. I felt horrible that I had thought of the patient as a block of time and not as a human. (Let me be clear yes, I know we as hygienists all have a set amount of time to see our patients and that time is not unlimited so yes, we do see patients in blocks of time. But I am speaking to the way we think and treat patients.) So, I started really focusing on my patients, really getting to know them, asking them more questions about themselves as I was waiting for a sensor or doctors’ exam. I focused on trying to relate and really connect with each patient. Are there patients I clicked with much better than others? Yes of course! Are there some patients who I could tell would rather not talk much at all? YES! But 8/10 patients, I would say most patients wanted to converse and we would laugh, talk about tv shows or podcasts we were watching or listening too. I truly worked on relating to my patients and in time I would look at my schedule for the next day and I would see patients’ names and I was excited to see and visit with as I helped care for their oral hygiene. I would look at my schedule and I would say to my manager so many amazing fun patients are coming in tomorrow it’s going to be great. And those days and patients helped me change my mindset.
Since my mom’s hygienist left “change the frame of mind” open to interpretation I will also associate it to the pressure of being perfect. I don’t know about you as a hygienist, but when I left school, I felt this immense pressure to be the perfect hygienist, to say the right things and to always do everything perfect, perfect, perfect! I have learned to give myself grace. No one is perfect. We can try every day to do our best and of course treat our patients with the standard of care, but we are not perfect and that is okay. If you have worked in an office that has a morning huddle (which I think are great), when has the day ever gone as you planned in that morning huddle? NEVER!!!! There are so many things that are out of our control as a hygienist. Waiting for a doctor’s exam, a patient arriving late, technology issues, operatory issues, the list goes on and on, you know this! But what helped me in those times of looking at the clock and thinking oh my gosh I have seven minutes left in the appointment…. I still need the doctor to come in here and not chat my patients ear off…. I still need to place fluoride varnish AND flip my operatory over….. how am I going to do all of that?! Well, the thing is that I didn’t have control over some of that. My best advice is to remember that and to focus on the patient in your chair. If the patient in the chair feels like you are going to be rushing them out the door, or that you are frustrated with the doctor or whatever circumstance that is out of your control, the patient will not want to come back and be seen by you or maybe that office again. It is okay to apologize to the patient and let them know the doctor is coming, and that they know we are ready for the exam. While you wait for the doctor spend time educating, scheduling their next appointment, getting to know them, and connecting with them. Then when you bring the next patient back make sure to say thank you so much for waiting, it’s great to see you again or it’s so nice to meet you, let’s get you back! If you make each of your patient’s time with you feel valued and appreciated, you can have patients who are happy to come back and see you.
I would also like to recommend two things that also helped me out of my rut- education and community. I had the opportunity to become a clinical instructor at a dental hygiene school about 3 years into my dental hygiene career I truly feel that I became a better hygienist by being able to explain and teach students. I felt that explaining how to do instrumentation techniques, or explaining why I do something helped me solidify the things I knew. Being at a college also helped me stay very up to date and continually learning other tips and tricks from other hygienists! You may be reading this thinking; well, Sarah, I don’t have that same opportunity to teach at a college. That is okay. Maybe something you can do instead, is to ask yourself the why you do the things you do during your appointment. Why is the OCS so important? That can open a door to you doing research on nodes, muscles joints etc. and can help you learn. Deep dive into the things that aren’t your favorite things to do or skills you don’t feel as confident in and try to immerse yourself to become an expert in those things!
Community! I do hope that you are a part of your association, within our dental hygiene association we have components that meet, and you literally be among other hygienists that are in your physical area, and you can network. You can make new friends and meet up with old friends and really get to talk to other hygienists, that may have similar feelings of being a rut too. Being able to bounce ideas and get advice from others who truly understand situations you may be in, is so helpful. I hope this has helped you if you are stuck in a rut. If you are in a rut, you are the only one who can get yourself out. You can do it and feel excited about your career again. You have got this!
xoxo, Sarah Bateman, RDH
Sarah has been a dental hygienist for eleven years and has been in the dental field for 17 years. She lives on a ranch with her husband and their little boy who is almost a year old. Sarah has worked private practice and was a clinical instructor and professor at the Utah College of Dental Hygiene for 8 years before she had her baby and moved to their dream ranch in Idaho. She still temps in private practice two times a month right now while enjoying baby cuddles.
Interproximal Brushes with Tepe
When I think of myself as a patient and a human, I love a more individual approach to anything. What’s the best hair product for my wavy and bleached hair? What’s the best skin care for my specific skin? Patients are looking for this too, since there are so many different products on the market to try out and experience with. We can do this in our practices as well, making individualized recommendations to our patients to help improve their oral and overall health. With Tepe Interproximal brushes, we can determine one or several specific sizes of brushes for your patient's individual needs. Plus, determining which brush is needed can be found with an instrument you already use every hour- a periodontal probe. Check out this video to learn more about sizing of Tepe brushes, and how you can add this service to your practice.
Interested in learning more about about Tepe? Find more information on their website or reach out to Heather for your very own webinar to get more information and start recommending these amazing products to your patients.
xoxo Melia
Simple Ways to Save Time During Periodontal Therapy
We all know the feeling. We’re running behind for the day, and your next appointment is a periodontal therapy appointment. Sometimes, those appointments are stressful enough. But adding the time crunch on top if of it can make it absolutely no fun. Or, if you’re a student getting into the thick of learning how to treat periodontal disease, there is never enough time in a clinic session to finish everything. Here are a few helpful tips to make your next periodontal therapy appointment go a bit smoother.
Use something to help manage the water. Mr. Thristy by Zirc, the Releaf, Aersol Assist, just something to help keep the water at bay. Lots of time is used up by managing the low volume suction, making sure you’re in the right spot with it, or having to stop so the patient doesn’t drown. Save the hassle of figuring it out by using a device specifically designed to be comfortable to the patient and to manage the water from the ultrasonic.
Utilize your radiographs. As you’re instrumenting, do you feel somewhere weird? Not sure if it’s calculus or tooth? Look at the rads! They are your under gum road map to show what’s happening subgingivally. Take the few seconds to look as the tooth, instead of instrumenting over and over with no success.
Focus on the basics. Make sure you’re sitting at the correct chair position! I see this all the time- clinicians always sitting in the same 9:00 position, and straining to see so many areas, and probably missing lots of areas because of it. Moving your operator chair to 12 will make a huge difference with your time management, not to mention your ergonomics.
Make sure your instruments are sharp and ultrasonic inserts aren’t worn before the patient comes. You’ll save oodles of time if you’re not having to put as much pressure as you scale, or have to go over an area several times. Making sure you working instruments in their best condition will help.
What do you do to help save time during periodontal therapy?
PSA Injection with the Kilgore International Anesthesia Manikin
When I think of a PSA Injection, I always think back to when I was a student taking my WREB board local anesthesia exam. Back then, we were able to take this exam as classmates, and were able to sit for it. One of my friends from my dental hygiene class asked if I could be their patient, since her original patient last second had class. I knew it would be tricky on me. My skull and anatomy for the IA is perfect! PSA is a different story. I definitely have extra tissue on my cheeks, even back in dental hygiene school when I was 21 years old, which makes these angles sometimes hard to imagine. Turns out, she ended up not being able to get the correct angles with my face, and had to redo the injection later that afternoon. Of course, she passed with flying colors.
But what are the correct angles when it comes to the PSA? It can be difficult to imagine, especially when you have to think of them spatially in a 3D way and tissue tends to block how they can be seen. Getting all three correct can be tricky, but with patience and practice, you will totally be able to get them down. We loved practicing and teaching this injection on the Kilgore Anesthesia Manikin, since you can easily see the three needed angles, and get immediate feedback if you’re in the correct area. Plus, practicing these injections beforehand on a manikin instead of a human can help build confidence in the new dental, dental hygiene, or injection student who is feeling apprehensive of giving a shot to a real patient.
To review these angles to make sure you’re getting the most out of your PSA injection, check out our latest video.
How do you feel about the PSA Injection?
A big thank you to Kilgore for supporting us here at Hygiene Edge! Without great companies like them, we wouldn’t be able to do what we do, or be able to learn as well as we have! To learn more about Kilgore International, check out their website: https://kilgoreinternational.com
How To Study For National Boards
I get asked all the time how to study for the National Board Exam. I like things in black and white myself and wondered if there was a secret recipe to passing that exam when I took it. So here is what I figured out, and what I tell those who are looking for guidance.
I recommend studying the way that you usually study to get and “A” on an exam. For advanced planners, like myself, I recommend studying in advance. For those that are crammers, I recommend... cramming.
Studying In Advance
For a regular exam, I had to read the chapters each 2-3 times, then review with my study group/myself the review questions 2-3 weeks in advance. I would make a study schedule to pace myself.
For the National Board, I did the same. I was scheduled to take the exam at the end of March so I made myself a study schedule that started in January. Each week I scheduled myself a topic to review and that process took about 2 months time. For the last month, I practiced test questions from the back of each chapter in the study book I used and any other practice questions that I could get a hold of. I, personally, have a little test anxiety and really had to learn to read through questions thoroughly. I would also look at the answers and find out what would have made those the correct answers.
The last week before the exam I didn’t do any studying. I figured that if I didn’t know it then, I wasn’t going to.
Cramming
Now if you are a crammer, I recommend cramming. Check into a hotel or lock yourself in your room the weekend before. Get lots of healthy food and study until you drop. If you like to study as a group, invite some friends. You may also want to consider using a board review course as your “cram” session.
Hybrid Version
If you like portions of the above options, consider mixing them to meet your needs. Whatever you choose, make a plan and stick to it.
What Sources To Use
I would recommend looking at all of the options and seeing what is the best for you and limiting it to 1-3 of those. Otherwise, it gets overwhelming. Consider that you will want them to be thorough and you want it to have practice questions with explanations as well.
Study as you go
Last is to do well in your current classes. Consider that with each class you take, you are studying for the board. Those who usually fail are those who didn’t do well in their classes in the first place or those who chose just to “wing” the exam and don't study anything. If you can get at least “B’s” in your classes and study some, you have very high chances of success. Best of luck- now go study!
Be sure to check out our YouTube Board review playlists on our channel for more practice.
Let us know in the comments what you used to study from for your National Board Exam.
Mouth Taping for Better Sleep with OI Tape
So we’ve all seen the amazing trends that come out of TikTok. And when I say amazing I mean sometimes very questionable. Whiten your teeth with magic erasers? Yikes. Closing your diastema with a little elastic or a piece of floss? Oh dear. But, have you seen the latest one of taping your mouth shut as you sleep? This is actually a trend that I can get behind since there is supportive research behind it. We all know that breathing through your nose is healthier than breathing through your mouth. We can get deeper breaths, stay healthier, and ultimately fall asleep and stay asleep longer. It also helps keep the mouth close as you sleep, preventing dry mouth throughout the night and when you wake up. This is a great option for patients that want to try something to improve their sleep that is very non-invasive.
Now, what mouth tape should they use? Not all mouth tape is the same due to the materials used, the effectiveness of the tape, or the comfort for your patient. You definitely want to make sure your patients are using a mouth tape that’s comfortable to the skin, easy to remove, and safe to use when sleeping . We have tried out several different types, and honestly I love OI Tape the best. It comes off easily, doesn’t pull the skin, and actually can be used on patients if they have a beard or mustache. Most brands recommend the patient shave before use. It is definitely something worth checking out if you or your patients are having a hard time sleeping, tend to snore, or wake up with dry mouth every morning.
Have you tried mouth taping before, or have patients ask about it?
xoxo, Melia RDH
Great Research Articles
https://journals.sagepub.com/doi/abs/10.1016/S0194-5998(00)70147-1
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2003-40664
Why I Attend Our State Dental Hygiene Capitol Day
Each year, our state dental hygiene association hosts a day at the Capitol for dental hygienists all over Utah. It’a a day where everyone gathers, chats about access to care or needs in the state, and connect with others, both dental hygienists and representatives, about what’s happening in the real world and in our communities. Honestly, attending this day isn’t always the easiest. It’s held on a Friday, so I have to take a day off work which I don’t love doing to my patients. Second, our legislative session is always in January through February, which means it’s the coldest part of the year here in Utah. Third, parking at the Utah State Capitol is a nightmare. You usually have to park a mile away and wake through the dark and cold to get to a 8:30am start time meeting. But, even with these little annoyances, I still mark it on my calendar each year and make it a priority to go. Why?
1. It’s important to be visible on a legislative level when it comes to our profession. Our profession has a license attached, which means there’s laws and rules associated with it. Those laws could technically change anytime with a vote from our states House and Senate. These elected officials probably don’t know much about oral care. They’ve probably never even though of it, unless they had a toothache or during their 6 month recall appointment. They probably don’t even knows what a dental hygienist is as compared to a dental assistant, and we should be the ones to help dispense the information.
2. It’s great to be an involved citizen. You’ll get to know you’re elected representatives in your area and not only become a support your then with dental issues, but any legislative issues that effects you and your family. Since there are laws passed each year that effects us, this is the perfect time to get up to date on what’s happening, and see the changes that are occuring.
3. It’s inspiring to connect with others who feel passionate about dental care in your state. Feeling burnt out with dental hygiene? Going to the Capitol and speaking about your passion can relight that fire! Connecting together for a common goals grows the community of dental hygiene, and always relights the spark inside me to keep going with this profession.
So, if your state currently holds a Day at the Capitol, take the time to go! Even with the little annoyances that the day could bring, it definitely brings out the best in you and the profession. If you’re local to Utah, come with me next February!
xoxo, Melia, RDH (@meliardh)
