By DR SIMON HOCKEN
I love my hygienist. Well, actually, I love how my mouth feels after 30 minutes lying in her chair.
I have to admit, I’m not a great patient and her ultrasonic scaler tip has a habit of finding my exposed dentine and making me jump as if I were wired to a battery…
However, I’m reasonably stoic (or so I tell myself) and half an hour later, I’m out on the street, £50 lighter and running the tip of my tongue around my newly shined lower incisors.
£50 feels about right; I had my hair cut last week, it was £33, took 45 minutes plus I got a cup of good coffee! Would I pay more? Probably not, I’d probably treat myself to a super-duper new electric toothbrush…
I suspect my hygiene visits are pretty much the same as yours. They go something like this:
- A quick prod with a pocket probe
- A careful and thorough ultrasonic clean
- A bit of a polish
- A chat about my holidays
- A “see you next time”
Now, this sort of works for me. My perio is reasonably under control I think, although, how would I know? I have a few 5mm pockets around large restorations and a family history of perio problems but hey, I’m in her hands…
The real issue for me is that it feels so old fashioned. My hygienist appointment follows the same script that my own hygienists used in the 1990s and the whole structure is the same (why half an hour, why £50, why two times or four times a year? Why, why, why? Is there any rationale for any of this?).
Now we know so much more about the link between periodontal disease and systemic disease, surely it’s time to reinvent the 1990s hygienist appointment for people like me.
Why people like me? Well, let’s see; I’m 59, slightly overweight, on medication for hypertension and I have a family medical history that includes type 2 diabetes, strokes and heart problems. Maybe a trip to see my hygienist might be about something more useful than just cleaning my teeth?
I think I would appreciate (and more to the point, pay more for) an appointment that included some or all of these components:
- A review of my current medical history and lifestyle highlighting areas where I am putting myself at risk. This might include dietary analysis and a BMI score
- Some screening procedures such as blood pressure, blood sugar, cholesterol
- A full examination, at least once a year, including some patient-friendly indices, use of a Florida Probe, some photos and visuals of the condition of my gums
- Some diagnostics, treatment planning and the reason why any periodontal disease is still active
- A careful and thorough clean
- Help to focus on any areas where there is active disease
- Finesse oral hygiene
- Top ups and recommendations to supplement my oral hygiene tool kit
- Something to take away to remind me of where I still have active problems and what I can do to help
- Agree when I need to visit next and for how long
I’d be willing to pay £100 for this and I wouldn’t miss the banter about my holiday. And I will probably live longer. Even better, I’d like to join a plan and pay £33 a month and not have to think about the cost and the value. I’d go more often and my dentist would probably see me more often too and I would have my teeth checked on two out of the four appointments.
Now, isn’t this a little more 21st century for us worried well, over 50s? Surely it’s time to offer more than tooth cleaning… Oh yes, and I’d really like a Saturday morning appointment please!
One last observation, I don’t think my dentist knows what his hygienist is up to during these half hour sessions, and I suspect you don’t know what yours are up to either. Maybe it’s time to reinvent the tooth cleaning visit.
With all good wishes,
Simon
Hi Simon,
I absolutely agree that every appointment with a Hygienist should include risk factors, screening and indices of current disease, and information and education on systemic influences in relation to Periodontal disease. The appointment must also include thorough treatment (‘cleaning’), and bespoke coaching on how the patient can take responsibility for their own disease. Polishing with ideally an Air polisher, post operative instruction and recommendation for the interval for their return visit. Add to that Implant Maintenance and that just about covers it.
So yes, let’s do that at every appointment, this is what you will find most Hygienists are striving for. BUT, each appointment would take an hour, so basically double your appointment time and you CAN double your fees! I know Hygienists are expected to be Superwomen, but you can’t really expect any of us to cover all of this in half an hour!
Kind regards, Helen Parkin.
Hi Helen,
I’m sorry that you may have misunderstood my article. I would not expect Hygienists to carry out the appointment I outlined in half an hour. In fact my suggestion was that this sort of appointment needs an hour and this will in effect double the practice Hygiene sales.
It is (of course) up to the prescribing dentist to sell the benefits and the fee for this appointment.
Best wishes
Simon