A new direction for dental hygiene
Claire Berry shares her experiences developing her career in hygiene and therapy since leaving the army, how she faced the challenges of 2020 and what she hopes for in the future.
How do you feel practices can use a dental hygienist or therapist’s skills to best effect for patients?
Claire Berry (CB): Obviously, you’re taught a wide range of skills at undergraduate level and it’s important we get to make full use of them in practice.
This idea that hygienists just scale and polish is history. Nowadays, we are all set not only to help patients keep their teeth and gums as healthy as possible but also to support dentists’ treatment plans.
In my practice, every patient sees me as a matter of course. So, for example, if they have attended for a consultation about implants, they are asked, as a next step, to see me.
For any treatment to go ahead, a patient needs stable oral health and to have committed to ongoing hygiene care.
I’m a bit like the gatekeeper to restorative dentistry. After all, there’s no point having potentially extensive and expensive treatment if it’s all going to fail as a result of a patient’s poor hygiene practices.
And that’s not just from an aesthetic and functional point of view – there’s also a litigation aspect.
If a patient’s notes show a commitment to ongoing care, that’s a really important aspect of refuting any possible claims from upset patients.
How does that kind of integrated approach to care shape the business of dentistry?
CB: When a patient comes to see me, I know that our teamwork approach is the best way of helping them to achieve lifelong oral health. That increases patient retention and encourages them to make their next appointment before they’ve left the practice.
I think if you use your hygienist properly, the focus is not that it is a money maker, because that’s not what it’s about. It’s what’s best for the patient.
Also, as a by-product of it being the best thing for the patient, it actually is a really great thing for the business as well.
How do you get a patient to book for the next appointment before they leave the practice?
CB: It’s really about how you communicate with patients.
When I talk about oral health, I never just say: ‘Oh, this electric toothbrush is the best electric toothbrush.’ That’s a bit of a woolly idea for a patient to take on board.
Instead, I want to explain their disease. I want them to know the science behind their disease. For example, if you said to a diabetic: ‘You’ve got diabetes, don’t eat sugar,’ it kind of makes them feel like they still have an option.
But if you say: ‘Right, you’ve got diabetes. This is what happens with your diabetes. This is what your body is doing, and this is what happens when you eat sugar. If you continue to eat sugar you can end up with serious issues, even issues like needing amputations and it can even lead to death.’
When you speak to someone like that, they realise that there’s no option in the matter; either you do it or you suffer the consequences.
With periodontitis, it’s a similar thing. I want them to understand the science of their disease, because when they understand what it does to the oral cavity, or how their immune system may react to the presence of biofilm, or understand the immune and inflammatory processes, it’s an eye-opener. They then understand the importance of seeing me again.
What I share with them enables them to take control of their disease and their oral health. I’m just there to coach them and guide them along the way, really.
How can a hygienist get started on a similar positive pathway?
CB: When I left the army and became a civilian hygienist, I wondered where to go next with my career. There was no rank to work towards, no obvious ladder of promotion any more. That didn’t sit well with me, because I was always looking for the next course I could do that could get me a promotion. I like to better myself. I like to be working towards a goal.
So, that’s when I started treating my dental hygiene skills as a business.
I decided I’m not someone’s hygienist. I am a hygienist yes, but I’m my own boss, and I work alongside clinicians in practice.
That mindset gave me the impetus I needed to start investing in myself and my business.
One of the courses I then went on was about guided biofilm therapy (GBT). I was blown away by the protocol and knew I wanted to offer that instead of the traditional scale and polish to my patients. I was prepared to invest in the equipment myself, such as Airflow, Perioflow and Piezon No Pain, but I also needed the dentists I worked with on board, so they would be prepared to refer patients to me for GBT.
So, I did my homework and put it to my colleagues before I invested.
That went well and actually such was the success of GBT in my hands that I then became a Swiss Dental Academy trainer, helping others to move forward with GBT in their practice.
I get that having to present the idea of GBT to fellow team members can be daunting. There is help from EMS on that score. If you can persuade your dentists and other team members that it’s worth allocating 90 minutes to meet with an EMS rep, they can do the rest in a pressure-free way.
Last year was obviously a really odd year. What was 2020 like for you professionally?
CB: When COVID-19 hit, I had just started working part-time at a new practice in Leeds and, of course, that shut down in March. We were then having a Zoom meeting every week. I started providing Powerpoint presentations on non-clinical skills like motivation. Also, on clinical topics that focused on biofilm, and so on. So, I kept my hand in with virtual teaching sessions.
Then, when we were able to reopen, I started working one day a week there. Then two, then three. It has now got to the point where I’m fully booked until the end of May!
I think lockdown made patients appreciate us more because they couldn’t have access to us. They know that access to dental care can be interrupted by the unknown and unexpected. They want to stay on top of their disease and health in case. Sadly, some people did return with increased periodontal issues, and that has worried them.
More than ever, prevention is so important and patients are really recognising that in the wake of the COVID-19 closures.
What do you think this year might hold for you and for your fellow DHTs?
CB: I can just see a shift in how we’re being utilised in practice. I think people are starting to notice that the dental hygienist’s job is evolving. We are doing more than just what people consider a scale and polish.
More and more hygienists are setting up their own practices, facilitating direct access. I think we’ll become more autonomous over time, as awareness grows among the public about what we can offer.
They’ll learn when they need to see a hygienist or therapist and when they need to see a dentist. They won’t automatically assume that an oral health issue requires a dentist. Preventive periodontal care is our bread and butter. If more people knew that, it would free dentists up to do what they are best at doing.
I think there needs to be a step change in terms of people really understanding what the hygienist does. I am well down that path, armed with GBT, and I couldn’t be happier or more hopeful about the future.
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