The hygienist’s blog – introducing ‘oral health optimisation’

This month Claire Berry discusses how to upgrade the ‘scale and polish’ so that patients appreciate the importance of good oral health.

I got to work the other day and the practice owner came to me before our daily practice meeting. They said: ‘Claire, think of another name for your services please. I am going to refuse all the clinicians from referring to your treatment as a scale and polish from now on.’

He went on to say his reasoning for this. He realised what I bring to the table is far more than a scale and polish. And he considers my role as not just important in the patient journey, but absolutely essential.

Therefore he wanted to adapt how my treatment was discussed with patients and colleagues. He hopes the changes would reflect how important it was in the overall treatment plan.

The oral health optimisation

After deliberating we decided to call it ‘oral health optimisation’.

Expanding on from this, I decided we should refer to it as a programme. Then the patient will immediately consider it as an ongoing process with multiple visits.

The patient often associates a programme with education or learning. I will ultimately coach them to health.

The long-term aim is for the patient to transition, once oral health is optimal, into an ‘oral health maintenance programme’. This is life long and at a recall that suits their individual situation.

The patient will only have the ability to have some available treatments, such as implants for example, once they achieve oral health optimisation.

Then once established and able to move into a maintenance programme with appropriate recalls, it will ensure the work they have done will last. This will then hopefully mean they will have life-long optimal oral health.

By having these discussions right at the beginning of their treatment plan, they are more open to the advice I have to give. More open to the treatment I have to carry out. And more open to the need for their oral health and disease stability to come first.

They’re more onboard with the cost of my treatment and the need for multiple visits to see me.

Professional prophylaxis of disease

Now, I am aware this whole concept isn’t new. I have absolutely not re-invented the wheel.

But it was a great feeling to have the whole practice now want to physically change the way they discuss my treatment, to change the way they refer treatment to me and consider what I do as far more than simply a ‘scale and polish’.

To have them say they see it for what it actually is, to realise it is not a scale and polish, not something simple or easy to complete, that it’s not the same for each case, it’s not something that can be achieved in one visit and that it’s also not something that can be done in 20 minutes.

It’s the professional prophylaxis of disease and we are experts in our field. Prophylaxis is defined as the ‘treatment given or action taken to treat and prevent disease’.

‘Scale and polish’

My choice of professional prophylaxis is putting biofilm control at the forefront of my treatment. Therefore I chose to invest in the equipment required to allow me to perform guided biofilm therapy (GBT) on my patients.

I do believe bringing GBT to my practice has helped induce the realisation of how a hygienist’s treatment has evolved over the years.

I also believe lockdown may have helped more people appreciate our professional role and how we are leaders in prevention.

Prevention and prophylaxis has never been more necessary than it is now with the potential for reduced access to care.

I can honestly say that it was a thrill to have that conversation that morning. But especially to have had that conversation without any prompting.

Should I feel fortunate to work with a practice owner that genuinely feels this way about our profession? Or rather, is it a sad state of affairs that I feel lucky because this should actually be the norm?

I know there are many out there who do work with fantastic owners like this. But disappointingly, there are still so many who do not.

I have worked hard to get to this point at my practice. But I guess because there are so many hygienists who still have the ‘scale and polish’ battle on their hands, I do in fact feel very fortunate.