The EME approach to tackling oral hygiene education
Amber Ojak introduces her EME approach to oral hygiene education, which will help influence behaviour change both in and out of the dental practice.
Periodontal disease may be one of the hardest things to treat. It predominantly depends upon patient compliance. We have all the latest available equipment and skills required to provide ‘gold standard’ treatment. But without patients taking on board our advice, and maintaining their own oral hygiene at home, we cannot achieve the optimum result.
After lockdown, I’m sure many of us have thought about specific periodontal patients. Those who have had to stop treatment are due reviews, or had not even started their periodontal plan.
As a dental therapist, I will admit there are quite a few patients I am thinking about. I wonder what things will look like in relation to their oral cavity when we return to the surgery. When it comes to treating my periodontal patients, one of the main things I have to focus on is patient attitude to their oral hygiene. Making sure they understand that what they do at home is just as important as what I do in the surgery.
I have broken this technique down into my ‘EME’ approach, which comes in two parts.
The first part of ‘EME’ stands for ‘educate, motivate and encourage’. These I consider the three most critical building blocks in getting patients on board with their oral hygiene routine.
The second part of ‘EME’ stands for ‘encourage, maintain and enjoy’. This links to what patients will do once they have experienced the first part.
Education is one of the most important words for me when I treat my patients.
I find that quickly going over some oral hygiene advice, without explaining the basics or what is causing the problem in the first place, results in less compliance from my patients. By taking the time to teach patients why they have periodontal pockets, what causes these, and the role bacteria play, will help them fully understand the importance of good oral hygiene. A lot of the time, my patients do not know what causes the problems. They say: ‘Oh I thought it’s just because I don’t use an electric toothbrush’. Or: ‘I thought bleeding gums are normal’.
Making sure our patients know the aetiology of the disease means they can visualise it themselves. This helps them understand why oral hygiene routines are so important. Spending the time going through the basics will mean no patient is stood in front of a washbasin asking themselves why are they bothering to use their toothbrush or interdental aids.
They will finally be able to understand why they are experiencing problems such as bleeding gums or sensitivity. They’ll know what causes these problems meaning they’ll want to know how to prevent it.
As dental professionals we know every patient will have different needs in terms of oral hygiene instruction. Some will need more, and some will need less.
Motivation plays a massive role for me when I am going through oral hygiene aids and it is the second part of EME.
I have found that motivating patients creates a difference in how patients look at what they are doing at home. For example, when I go through toothbrushing instruction with my Oral B Test Drive, I can help to motivate patients to brush correctly and more effectively by physically telling them they’re doing an excellent job, altering their technique perfectly. I suddenly see the patient’s own motivation soar. They have learnt a better way of doing something, and know the background to why this is important.
The Oral B Test Drive is a wonderful tool when educating and motivating patients. It allows patients to feel and experience an electric toothbrush; maybe they don’t use one. Or it allows them to feel whether they are putting too little or too much pressure on their teeth.
The same response happens when I talk to patients about flossing or interdental aids. Showing them the correct way to use these tools benefits them individually. They try it in the practice and know they can repeat this at home. It motivates them to do so.
The third word of EME part one is encourage. I always actively do so with all my patients. A little bit of encouragement goes a very long way.
Patients can feel uneasy and a bit deflated when they are told they have periodontal problems, so knowing they have our ongoing support and that we are there to turn things around can make the world of difference.
Telling patients that we understand how they feel, but that we are there to make sure they succeed in their own journey, provides a level of comfort. They know they’re not on their own.
At every appointment, I keep encouraging my patients to keep up their oral hygiene at home. Many of them who stick with it see huge progress in a short space of time. And they know we can adjust things if they are struggling.
I praise every little bit of progress made – even if it’s moving from brushing once a day to twice, or using floss for the first time.
Patients flourish with positivity. And by having the education, as well as being motivated and encouraged, I find the barriers to treating periodontal disease are eliminated.
Encourage, maintain and enjoy
Once a patient has experienced the education, motivation and encouragement, part two comes into play.
Patients are now encouraged to use the techniques they have been taught to enhance their oral health and hygiene routine at home. They can maintain this going forward. The last word is enjoy, because I want patients to enjoy their oral hygiene care. We spend so much time on beauty and healthcare products, so why can’t we enjoy our oral hygiene routine too?
With my ‘EME’ approach, I can finally bridge the gap with education in the dental surgery and how the patient looks after their oral health at home.