The role of the dental hygienist has shifted massively from the days of scale and polish. This month, Claire and Faye discuss the range of services hygienists can offer, highlighting the importance of maximising their potential.
The scope of practice for a 1950’s hygienist, when the profession came to be, was literally scale and polish. It was from a time when it was considered that calculus was the problem.
It was thought that calculus was the cause of disease and that the removal of it would treat and prevent periodontitis and caries. But fast forward 70 years and we now realise biofilm is the issue. We know more about dental disease, how disease is caused and how we can prevent it.
As this knowledge has developed, so too has the role of the clinicians who are responsible for the primary treatment of disease and prevention. Consequently, the role of a hygienist has evolved over the years.
As this evolution occurs and as we continue to learn how the mouth affects the body as a whole, the hygienist’s responsibilities now include optimising oral health in order to optimise systemic health and we are essentially the health experts in the team.
With this shift in the hygienists’ role and responsibilities, now is the perfect time to maximise the potential of the hygienist and enhance the services this pivotal department can offer.
General health screening
Are we truly optimising oral health if we are not considering the implications some systemic conditions can have on dental disease. We also see a higher proportion of the public in a dental practice compared to general medical practice.
We are well placed to spot medical anomalies early and initiate the right intervention. Screening could include HbA1c and diabetes screening, with this being highly linked to periodontitis and success of treatment outcomes.
Blood pressure, cholesterol and screening for obesity can also improve periodontal treatment outcomes and improve the overall health of your patient base. Not to mention the effects of profitability in a highly ethical way.
Tooth whitening
A fantastic time to have you tooth whitening top up is immediately after a hygienist visit, when all surface contaminants are removed and the enamel is ‘naked’ to allow the hydrogen peroxide to provide great results.
Get the patient to bring their whitening trays and place the 6% HP in as the treatment ends. You can add varnishes to any exposed dentine, allowing hypersensitive patients to be able to top up their results.
Or Blancone in chair whitening in 10 minutes to give a temporary result for a special occasion. Charging an add on fee can boost the hygienist services.
Oral cancer screening
This is something we all do but rarely tell the patient we are doing it. I’m not suggesting charging for this as an extra, I’m suggesting making it apparent as a separate part of the appointment and making it lengthier and more obvious.
Maybe invest in some Goccles so that it is glaringly obvious that you are checking soft tissues for cancer.
Don’t be afraid to use the dreaded C word. Patients take comfort in knowing they’ve had a lengthy and thorough check and making it obvious as a separate part of the appointment adds further value to the hygiene appointment being a health appointment.
It also further reinforces that the hygienist is responsible for oral health further than the obvious gingiva and periodontium. Especially as we see patients more regularly compared to some other team members.
Introduce care and health treatments for specific dental procedures
‘Composite care’ appointments are every three to four months, or implant maintenance appointments are at least every three months.
Have recommended care and maintenance plans for general and cosmetic treatments you provide to ensure regular recalls. I have patients who are super healthy, so technically could be on a longer recall.
However, if they have veneers or composite bonding that requires care more regularly, I see them more often.
Smoking cessation clinic
As part of treatment and our risk assessment we enquire and talk about smoking.
If a patient is a smoker we give them smoking cessation advice, but an oral health department could offer smoking cessation counselling as a separate appointment if the clinician is trained to do so.
Could this be something you can offer your patients as another service on your service list?
Sleep deprivation and mouth breathing screening
We know so much more about what mouth breathing can do for facial development and overall health. Another interesting topic is sleep deprivation and it’s effects on health.
Hygienists are well placed to screen for, spot signs of and refer people to the relevant specialists when they note a patient who suffers from these conditions.
Patients also care more about this. Just this week I was chatting to a patient who asked if they had any intra/extra oral signs of a sleep or breathing disorder because they listened to a podcast about it!
Saliva testing
This is often debated. Do we need to know what bacteria are involved in a patients periodontal disease to effectively treat them? Maybe not.
But it could be a great patient motivator and could be something that sets your health department apart, enhancing your hygiene services and boosting patient numbers through word of mouth.
A different and thought provoking experience means everything. It could also be the thing that changes a patients’ behaviour.
If you change your mindset to see and talk about your hygiene department as a health department, it makes it easy to see how you can maximise its potential and enhance its services.
Read previous Contemporary Hygienist columns:
- Paying attention to patient learning styles
- The importance of being assertive
- Adopt an ‘associate hygienist’ mindset
- Referring to a periodontal specialist
- Navigating pressure in an isolated job.
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