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A native North Carolinian, Jenny is a registered dental hygienist, holding an Associate of Applied Science degree in Dental Hygiene from Guilford Technical Community College (2006). [Our questions are in italics.]
Jenny, what is a dental hygienist? How is that different from being a dental assistant?
A dental hygienist is a licensed dental professional who has completed an associate's or bachelor's degree program with a focus in dental hygiene and passed a national and state board exam. A dental hygienist works independently with patients while focusing on preventative dental care, patient education, and therapeutic dental treatments, all in collaboration with a dentist. A dental assistant is a certified dental professional who has completed a one-year program. A dental assistant's job consists of preparing a patient for treatment, setting up the dental operatory for various procedures, and working directly with and assisting the dentist with basic and major dental procedures.
We understand that prevention is your focus. What do you recommend to people?
I recommend that people brush at least two times a day for at least two minutes, focusing on all of the surfaces of the teeth—outside, inside, and biting surfaces. I recommend they use some type of oral mouth rinse, preferably with fluoride in it. And I recommend that they floss. I always encourage patients to floss at night before they brush, to remove trapped food from throughout the day. Flossing before is a way to actually ensure that it gets done, versus postponing flossing until after brushing, when it is more likely to be skipped.
When a patient comes for a check-up, we begin by first updating any medical or medication changes. Next, I ask if they have any questions or concerns with their mouth for me and/or the dentist. Then, before we begin the dental cleaning, I update any necessary x-rays. I then clean and polish the teeth while updating any dental charting, including probing to check dental bone and gingival health. At the end of the dental appointment, the dentist completes the exam and the dentist and I collaborate to determine any dental follow-up needs. Then I review any of these needs with the patient through explanation, use of x-rays and intra-oral photos, answering any of the patient's questions.
What percentage of the American population have regular preventive dental check-ups?
I had a little trouble finding the percentage. What I was able to find is that appoximately 65% of people over the age of 18 in North Carolina reported having dental cleaning in 2010. But overall I would say that even when people have dental insurance, which usually allows for two dental cleanings a year, most patients usually only come one time a year, and often cancel or don't show. Each generation seems to be more knowledgeable about dentistry and the benefits of preventative care with regular cleanings, while the majority still tend to come to the dentist only for emergency visits based on acute tooth pain, with the mentality that you only go to the dentist when something hurts.
What, if anything, do you do when someone comes in because something's wrong? Does the dentist ever ask you for assistance in a case like that?
The first thing I do is get a detailed report from the patient regarding the area or tooth of concern, then an individual x-ray is taken if a tooth is involved. Next, the dentist comes in and I review the patient report, my findings, and any x-rays that were taken. The dentist may ask for assistance if any intra-oral pictures need to be taken, tx. plan fabrication, and also in reviewing and explaining the findings with the patient.
How do dentists and medical doctors coordinate their care for patients? Or do they?
Cardiologists have most commonly been in communication with dentists, as several heart conditions require pre-medication of antibiotics to prevent illness and infection. There is also communication between the dentist and medical doctors if a patient has had a recent surgery that required artificial hardware, again due to need for pre-medication. Doctors and dentists will also coordinate care if the patient is on anti-coagulants (blood thinners), as a patient may need to alter dosage for certain dental procedures.
This is an exciting question, because in the past few years I have noticed a trend that patients are asking questions about their oral health and how it relates to their overall health. In the past it was often thought that patients divided their bodies in half, thinking that the neck up was for the dentist, and neck down was for the doctor. But over the years, studies and education have progressed between medical conditions and their relationships and effects on oral health. Diabetic patients, for example, are learning more about the effects of good oral health and it can affect their blood-sugar levels. I have even had patients say, "My doctor told me I needed to come to the dentist." I get very excited because it makes me feel like slowly but surely dental education is growing and patients are "connecting" their heads to their bodies, which will ultimately lead to healthier people.
What are the main things you like about being a dental hygienist?
The main things I like about being a dental hygienist is when I see that the care, education, and services I have provided have helped a patient move forward with continued oral health and even changed their previous thoughts that their mouth was worse off than it actually was or that it could not be restored.
What's not to like about it?
That's a tough one. Like all jobs there are good days and bad days. Some patients are not able or willing to accept the proposed treatment and plan to help their mouth and that can be difficult when you know there is a way to help prevent further dental issues. However, having the opportunity to talk and interact with a different person every hour or so can help turn a bad day into a better day, because you never know what each appointment can bring.
You've worked in two or three dentists' offices, right? And you've probably talked with other hygienists. How do different approaches by dentists affect a hygienist's work experience?
Working in a dental office only works if each staff member operates as a member of a team. Each staff member plays an intricate role. Understanding and knowing the dentist's approach to patient care, treatment planning, and treatment will only enhance the hygienist's work experience by being on the same page and allowing the appointments to be more effective and efficient for the patient.
What are the one or two things about dental hygiene that you would emphasize for a healthy mouth?
First, do not skip brushing at night. Everything you have eaten throughout the day will go to bed with you and allow germs and bacteria to form in just a few hours. Second, nothing replaces flossing, so take the time and floss. It is the only way to effectively remove food and plaque from between your teeth. And three—sorry, but there are so many—don't miss your six-month cleanings and exams; early detection of dental issues means conservative treatment options and restored oral health.
We have a feeling that we haven't asked you everything that would be useful for our readers to know. What question or questions should we have asked—or would you like for us to have asked—that we didn't?
I think your questions were great, I would like to end with this: Dentistry has come a long way. If you are scared or have heard too many horror stories at the water cooler, remember those are probably from people who "waited until it hurt" to go to the dentist, thus causing only poor memories. Take control of your oral and overall health and go for your dental visits. You wouldn't miss an oil change or a hair cut—what makes the dentist any less important?
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