Dental hygiene, long the domain of dentistry, has been delegated to a growing group of assistants, the office hygienists.
Initially, dental hygienists focused on plaque and tartar removal, an examination of the mouth and then turned the data over to the dentist who provided the final assessment of a patient’s teeth.
Today, hygienists look for a wide variety of health problems. While tooth decay is still the primary culprit, hygienists screen for cancer, can identify the results of a poor diet and easily diagnose addictive drug use — typically called “meth mouth.”
Under supervision, hygienists are changing the routine of the dental office visit.
Shannon Ostransky and Sara Kellogg, hygienists employed by Dr. Nicholas Saeger, have both seen their share of unkempt teeth.
“Along with our teeth, our diet needs examination,” Ostransky said. “Too much sugar. Not only in our young patients. We see it in everyone. Too much soda. Diet or not. The diet brands just bathe the teeth in acid. Really not a good thing.”
Educating the patient and the larger population is a major part of a hygienist’s job expectation.
“We will spend much of any cleaning session talking about the latest research information available to us concerning prevention of decay. And now, there is a growing body of research linking the condition of a person’s mouth to various forms of cancer, diabetes and other intestinal issues,” Kellogg added. “We are looking a the larger picture in our dental labs.”
Hygienists are the first line of detection and, in some cases, diagnosis in the modern dental suite. When a patient makes the recommended twice-a-year visit, it’s the dental hygienist who first examines for potential issues.
“We are actually the major medical consultants for many people in their lifetime,” noted Miranda Garrett of Dr. Jim Wewel’s dental office. “So many people do not visit their doctor annually, yet will see us once or twice a year. So we take that big picture approach. We try to notice anything which may be indicative of a more pressing health issue. And we refer them to their personal physician. Today, we are part of a larger team of medical experts.”
All three hygienists graduated from the University of Nebraska Medical Center’s School for Dental Hygiene — a four year degree program.
Depending upon state laws, which vary widely, hygienists may inject Novocaine, complete minor fillings as well as the more typically expected teeth cleaning procedures. More and more hygienists are being allowed to provide services off-site, at schools or other public health settings.
“It depends on the state,” said Ostransky. “And the lack of dental care options in some rural areas. Where there is a need for care, it is often the dental hygienist who is on the job.”
Regardless of the physical setting, it is the role of the hygienist which has changed.
“There’s more to it than plaque, gingivitis and cavities now,” laughed Kellogg. “X-rays. Medical history investigation. Discussions about carbohydrates. But our responsibility still includes cleaning. We still focus on keeping those gums healthy for as long as we can.”
Garrett emphasizes education in the dental chair. And that simple lecturing does not seem to be effective. By creative use of mirrors, a patient can observe their own teeth. Often the reality of the condition of their mouth will be a motivator improve the daily routine of flossing and brushing.
“Mouth bacteria is especially aggressive. But we have better products today. More fluorine-based mouth rinses. Effective tooth brushes,” Garrett remarked. “But left unused, the best of devices and products will make no difference in tooth decay.”
“It’s still about brushing every day,” Kellogg said. “And flossing. Look, really, who wants to lose their teeth?”