Oral Hygiene November 2014 by Annex Business Media

oralhygiene November 2014

Breakthrough Blueprint

Building a

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oralhygiene CONTENTS

FEATURES Hygiene for the Edentulous Spot

Leslie Icenogle

Advancing Oral Wellness PART II

Sara DeNino Paone, RDH, RNCP

Healthy Recall – What Do Your Numbers Say?

Debra Engelhardt-Nash

The ‘Dental Hygiene Experience’

Kathleen Bokrossy, RDH

The Hygiene Department – Lifeblood of the Dental Practice

Cathy Jameson, PhD

DEPARTMENTS Editorial

CDHA New President; Ebola; Transforming Dental Hygiene Education Symposium

32 New Products 34 Dental Marketplace 37

38th ASDA International Symposium

Editorial Board Members Lisa Philp | Jennifer de St. Georges Annick Ducharme | Beth Thompson

Cover: ©danchooalex/Getty Images/iStockphoto

5 News 6

November 2014

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EDITORIAL

Dropping the Food Ball New data from the 2013 Canadian Community Health Survey showed that roughly one in five youths (20.7 percent) aged 12 to 17 reported height and weight that classified them as overweight or obese. And while most Americans will worry about eating too much this holiday season, 16 million American children live in households that struggle to afford food, according to a 2012 report from the United States Department of Agriculture. Four million Canadians, including 1.15 million children, lived in households that struggled to afford the food they needed in 2012. According to the Report on Household Food Insecurity in Canada (2012), the majority of food insecure households in Canada are working, calling into question the adequacy of existing government programs (such as the working income tax benefit) to compensate for the limited income associated with low waged, part-time, and insecure employment that many Canadian households rely on to feed their families. At the same time, 70 percent of households reliant on social assistance were food insecure in 2012, documenting the failure of these programs to enable sufficient access to food.

So what exactly is ‘food insecurity’?

©monticelllo/Getty Images/iStock

Food insecurity is the most broadly-used measure of food deprivation in North America. The USDA defines food insecu-

rity as meaning “consistent access to adequate food is limited by a lack of money and other resources at times during the year.” Acceptable shorthand terms for food insecurity are “hungry, or at risk of hunger,” and “hungry, or faced the threat of hunger.” Food insecurity can also accurately be described as “a financial juggling act, where sometimes the food ball gets dropped.” Food insecurity means an empty refrigerator. Food insecurity means soda instead of milk. Food insecurity means a child going to school hungry and unable to focus. Poverty may not look exactly the same in North America as it does in a war-torn region or a developing country, but it is affecting our children and their futures. Sometimes, working parents have to choose between rent and food, medicine and food, or gas and food.

Catherine Wilson Editor

What does ‘food insecure’ not mean?

Food insecurity is not “the government’s definition of hunger.” It is a broader term that captures outright hunger and the coping mechanisms that households use to avoid hunger. Food insecurity is a year-long measure. Therefore, it is not correct to assert that every food insecure household is experiencing food insecurity “right now,” will experience hunger “tonight” or “does not know where their next meal is coming from.” Research shows that food insecurity tends to be episodic and often cyclical. According to Health Canada, food security exists “when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.” There’s a lot to digest here (pun intended). As healthcare professionals, dental hygienists can play an important role in uncovering food insecurity and advocating on behalf of patients.

November 2014

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NEWS BRIEFS

Canada’s Dental Hygienists Elect New President The Canadian Dental Hygienists Association (CDHA) announced the installation of its new president, Mandy Hayre, at its recent annual general meeting in Moncton, New Brunswick. Mandy hails from British Columbia and joins president-elect Donna Scott (Yukon, Nunavut, Northwest Territories) and directors Gerry Cool (Alberta), Janel Parkinson (Saskatchewan), Mary Bertone (past president, Manitoba), Sandy Lawlor (Ontario), Sophia Baltzis (Quebec), Joanne Noye (Nova Scotia), Tracy Bowser (Prince Edward Island), Tiffany Ludwicki (Newfoundland & Labrador), and Wendy Taylor (New Brunswick) on CDHA’s board for 2014-2015.

Ebola Virus: Serving Others Where Ebola Is Present Ebola is a virus that once contracted leads to viral hemorrhagic fever diseases. Symptoms appear anywhere from two to 21 days after contracting the virus. Commonly the symptoms appear in eight to 10 days from exposure. The CDC lists symptoms as fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite, and abnormal bleeding. In order to get the virus, you must have direct contact with an individual who has symptoms. It is a severe, often fatal disease, with a fatality rate of up to 90 percent, according to WHO. At this point, there are only experimental A BUSINESS INFORMATION GROUP PUBLICATION Classified Advertising: Editorial Director: Karen Shaw Catherine Wilson 416-510-6770 416-510-6785 kshaw@oralhealthgroup.com cwilson@oralhealthgroup.com Editorial Assistant: Jillian Cecchini 416-442-5600, ext. 3207 jcecchini@oralhealthgroup.com

Dental Group Assistant: Kahaliah Richards 416-510-6777 krichards@oralhealthgroup.com

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Associate Publisher: Hasina Ahmed 416-510-6765 hahmed@oralhealthgroup.com

Production Manager: Phyllis Wright Circulation: Cindi Holder Advertising Services: Karen Samuels 416-510-5190 karens@bizinfogroup.ca

November 2014

Senior Publisher: Melissa Summerfield 416-510-6781 msummerfield@oralhealthgroup.com Vice President/ Canadian Publishing: Alex Papanou

Account Manager: President/ Tony Burgaretta Business Information Group: 416-510-6852 tburgaretta@oralhealthgroup.com Bruce Creighton

drugs used for the treatment of Ebola, and no vaccine is available for prevention of the disease. Standard precautions in infection control are a must. Things we take for granted need to happen with every patient, every time. Proper cleaning and disposal of instruments, such as needles and syringes, are also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak. Resources for treating patients with Ebola and precautions in the medical setting can be found at www.cdc.gov/vhf/ebola/hcp/patientmanagement-us-hospitals.html.

Symposium Outcomes Continues to Drive Change in Dental Hygiene Profession The “Transforming Dental Hygiene Education: Proud Past, Unlimited Future” symposium — a collaborative event convened by the American Dental Hygienists’ Association (ADHA), the Santa Fe Group and the ADHA’s Institute for Oral Health (IOH) – took place a year ago, but continues to affect positive change for the dental hygiene profession The three-day forum in Chicago brought together more than 100 key stakeholders with diverse perspectives to discuss the need to transform the educational requirements and practice for the dental hygiene profession. The symposium fueled the long-term multidimensional transformation of the dental hygiene profession by providing an outline for necessary steps and factors needed to advance the profession. Educational curriculum and programs will be the primary focus. For more information, visit www.adha.org.

OFFICES Head Office: 80 Valleybrook Drive, Toronto ON M3B 2S9. Telephone 416-4425600, Fax 416-510-5140. Oral Hygiene serves dental hygienists across Canada. The editorial environment speaks to hygienists as professionals, helping them build and develop clinical skills, master new products and technologies and increase their productivity and effectiveness as key members of the dental team. Articles focus on topics of interest to the hygienist, including education, communication, prevention and treatment modalities. Please address all submissions to: The Editor, Oral Hygiene, 80 Valleybrook Drive, Toronto, ON M3B 2S9. Oral Hygiene (ISSN 0827-1305) will be published four times in 2014, 80 Valleybrook Drive, Toronto ON M3B 2S7.

The contents of this publication may not be reproduced either in part or in full without the written consent of the copyright owner. From time to time we make our subscription list available to select companies and organizations whose product or service may interest you. If you do not wish your contact information to be made available, please contact us via one of the following methods: Phone: 1-800-668-2374; Fax: 416-442-2191; E-mail: privacyofficer@businessinformationgroup.ca; Mail to: Privacy Officer, Business Information Group, 80 Valleybrook Drive, Toronto ON M3B 2S7. Canada Post product agreement No. 40069240. Oral Hygiene is published quarterly by Business Information Group, a leading Canadian information campany with interests in daily and community newspapers and business-to-business information services. ISSN 0827-1305 (PRINT) ISSN 1923-3450 (ONLINE)

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ORAL HYGIENE Leslie Icenogle

Founder of Dental Implant Auxiliary Training providing lectures, coaching, and interactive webinars. Leslie has 30 years’ experience as an implant coordinator and practice manager. For questions or to grow your implants and your profit; contact Leslie at leslie@teamimplants. com

Hygiene for the Edentulous Spot D

ental hygienists are trained to save teeth, but also play a significant role in replacing teeth which will dramatically enhance patients’ lives… and your practice’s profit. Dental implants are the standard of care for tooth replacement today. With 30 years of experience as an Implant Coordinator in a specialty practice, I am often asked by hygienists what to look for when determining the candidacy for an endosseous implant. There are a lot of things to evaluate; let us take a look at some of these: MEDICAL HISTORY. In addition to allergies and blood thinners, look for digestive problems and/or history of GI surgeries. Ask your patients if they are taking any anti-acid medication (including over-the-counter) since patients do not always feel these are important to list. The oral cavity and tongue are listed first in the digestive system and play an important role in the process. We need to know if our patient is chewing their food properly. Also look for a history of oral or intravenous bisphosphonate use. Although there is more of a risk of osteonecrosis with extractions (due to the exposure of bone), it is important with implants to be aware of and to communicate with the prescribing physician, as well as inform your patient of potential risks through the consent process. Also look for uncontrolled type II diabetes, since these patients tend to heal more slowly and studies have shown them to have an increased chance of implant failure.

SOCIAL HABITS. Smokers. Cigarettes are associated with a variety of oral conditions including periodontal disease, bone loss, tissue loss, tooth loss, edentulism, periimplantitis and dental implant failure. The nicotine in tobacco has been known to decrease the blood flow in the mouth. Help motivate your patient to quit their habit and improve their oral (and overall) health. The benefits of stopping can be immediate and nicotine patches are often prescribed before implant therapy. Bruxism also needs to be considered when determining a patients’ candidacy. Night guards and/or restoring the implant slightly out of occlusion may be considered by the restoring dentist. Hygiene. Implants can fail for the same reason natural teeth do. Patients need to be both educated on, and committed to, hygiene and proper follow-up visits at your office before accepting implant treatment. Habits can be changed! Hopefully the investment of time and money will help motivate the patient, but educate them both verbally and in writing about the importance of homecare and of follow-up requirements as prescribed by the dentist. It is also important that, as the hygienist, you stay abreast of the latest recommendations of what instruments to use, and what ones to avoid around an implant borne tooth. Both patients and your dentist will look to you for guidance in this area (Fig. 1). PERIODONTAL DISEASE. There needs to be a healthy foundation to build a solid re-

November 2014 www.oralhealthgroup.com

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ORAL HYGIENE Clockwise from above: Figure 1. Plastic scaler; Figure 2. Figure 3. Ample ridge width and space for restoration; Figure 4. Supereruption; Figure 5. Bone loss.

placement tooth. DNA testing can be performed to determine if the disease is active or inactive. A bite analyzer can also be performed to determine if the bite forces contributed to the tooth/bone loss. Proper osseointegration of the implant requires healthy bone and tissue. HOW THE TOOTH WAS LOST. When a tooth is lost due to trauma, bone is often lost as well. Sometimes this requires the bone to be replaced via ridge augmentation prior to implant placement; making it a two-stage procedure that may take up to eight to ten months before final restoration. It is also true that when a tooth is congenitally missing, bone may have failed to form as well. It is helpful if the primary tooth can be maintained to preserve bone until the patient is fully grown, which is required for implant placement. EDENTULOUS RIDGE. Bone width and height need to be evaluated, often utilizing 3D imaging technology. During your routine examination, evaluate the edentulous area by feeling the bony structure. Is the ridge showing signs of atrophy of the buccal and/or lingual wall? This is common since disuse of bone leads to bone loss. In areas of single tooth replacement, there is a good chance that your patient is still a candidate for the implant. The bone will be augmented at the time of implant placement to allow for ideal location of the implant with the restoration in mind. However timely replacement may be important, which the patient should be ad-

vised about. If they do not accept treatment, at least you have informed them of the atrophy process. On completely edentulous patients, evaluate the ridge for a “knife edge” shape that may need to be reduced at the time of implant placement. Excess soft tissue that grows to fill an ill-fitting denture may need to be removed prior to implant placement; usually in a separate surgical procedure. Figure 2 shows buccal bone loss. Ideally, at the time of extraction, a socket preservation procedure would have been performed (which sometimes requires tissue regeneration with a resorbable membrane as well) to assure a solid, wide ridge for implant placement approximately three months later. Although there are implants designed for immediate posterior teeth replacement, these are often done in two-stages. (Anterior teeth can be done in one-stage.) (Fig. 3) SPACE. There needs to be ample room for the final restoration (width and height). Evaluate your patient’s mouth in a closed position. Have the opposing teeth supererupted? Is there enough room for the crown portion of the implant? Three to four mm of minimum vertical space is required for a posterior restoration; however dimensions greater than that achieve a more esthetic result. Also, is the tooth beside the missing tooth shifting to fill the void? Sometimes orthodontia is needed to open the space back up again (yet another reason to encourage timely replacement of a tooth). Models will then be studied by the dentist. (Fig. 4)

November 2014

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ORAL HYGIENE

Discussing implants prior to the dentist will create comfort with the process and excitement about the outcome

PANORAMIC EVALUATION. A panorex is often the first diagnostics taken, and since it is not a 1:1 ratio image, a measuring device is placed in the patient’s mouth during exposure to enable the dentist to make necessary measurements and determine the size of the planned implant. An implant requires 1.5-2.0mm of bone (depending on the area of the missing tooth) between it and the neighboring teeth roots. Panoramic evaluation will allow us to see where the sinuses and the inferior alveolar canal are located. Depending on the area of the missing tooth, approximately 7-13mm of bone height is required. SINUS LOCATION. Sinus lift procedures (both lateral and crestal approaches) are common. With the crestal approach, the implant can most often be placed at the same time. If the anatomy of the patient requires a lateral approach, it is often done four to six months prior to implant placement to allow time for the new bone to grow and calcify. This procedure requires a couple more days of recuperation and an intermediate appliance can usually be worn. NERVE LOCATION. This can sometimes be the biggest challenge. Although the inferior alveolar nerve can be relocated, it is still very risky. An option to replace missing posterior teeth is to place the implants more anterior (one on each side) and use locator attachments to secure a partial denture. If the patient has a completely edentulous mandibular arch, angled implants can be placed with the use of 3D technology with radiographic and surgical guides to avoid the nerve. This technology allows the surgeon to determine depth and angulation of the implants on the computer allowing for more precise placement which also allows for im-

mediate load of the prosthesis should the dentist desire. CT guided surgery also allows the patient’s time in the chair to be reduced significantly. Although building bone height can be achieved, it is much harder than creating bone width. There are options however. Technology gives us curved membranes with longer resorption time and titanium membranes. Bone can also be harvested from other areas of the patient’s mouth, or even their hip and placed in the donor site and secured with fixation screws that often need to be removed at the time of implant placement which has been done for years. Recuperation from this procedure is significantly longer. (Fig. 5) These are some things to look at when determining the candidacy for an implant. As a dental hygienist, simply evaluate the edentulous spot and point it out to the patient using a brief statement which can be scripted. What will the patient gain? Function, esthetics, preventing loss of additional teeth? You have a lot of influence on the patient and their decision to replace teeth. Discussing implants prior to the dentist will create comfort with the process and excitement about the outcome. Over the last three decades, one of the things I have learned is that losing a tooth is very emotional for patients. Knowing there is a secure and natural way to replace their teeth can be reassuring. Nothing is more rewarding than giving a patient back something they have lost, including function and self-confidence. Implants are the most successful procedure in dentistry! Although it may sound complicated, it is actually a very simple and painless process that leaves you with an extremely satisfied patient. n

November 2014 www.oralhealthgroup.com

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ORAL HYGIENE

Advancing Oral Wellness Through patients’ active awareness of periodontal health and nutrition PART II Sara DeNino Paone, RDH, RNCP

President of Smart Dental Practices, a company dedicated to working with dental teams to advance patients’ oral and overall wellness. Sara’s 20 years experience as a dental hygienist, including the last 10 as a holistic nutritionist, has helped her develop a view that an integrated, wholeperson centred approach best serves our patients. Sara is a member of the AAOSH, IONC, ODHA, CDHA, CHHO, as well as the Complete Oral Health Movement. She can be reached at www.smartdental practices.net

NUTRITION ASSESSMENT

As I have stated, overall health is a key factor supporting oral health. A nutrition assessment is an important tool to detect nutritional deficiencies in order to devise a suitable meal plan to improve overall health. A nutrition assessment form is given to the patient in advance to the Preventative Oral Wellness Program appointment. This fiveday food intake form outlines what they are presently eating. The record should include these important components: • a ll meals and snacks consumed and when, • portion sizes • i f they eat out, listing the names of the restaurants • a lcohol consumed • beverages consumed • how they felt after meals • their emotional state during meals Once patients have completed their nutritional assessment forms, oral wellness specialists are in a position to have a focused conversation with their patients about their nutritional needs. While it is not possible in this space to outline all nutritional factors that bear on all patients’ health, I’d like to highlight the ones that I regard as most important. What they have in common is that patients’ effective strategies in each of these areas can benefit their overall health as a key support for their oral health. They are: • hydration • sugar & stabilization of blood sugar • whole foods • a ntioxidants, essential fatty acids and probiotics

Hydration

Good hydration is an often under-appreciated pillar in the health of our patients and for many patients a key factor to address in their overall wellness. The average person is comprised of 70 percent water. Most of the bodily functions that go on in the body, including digestion, absorption, circulation and excretion, rely on the body being well hydrated. Water is also the primary nutrient transporter throughout the body and is necessary for all building functions in the body. Water helps to maintain normal body temperature and is essential for carrying waste material out of the body. Raising patients’ awareness of the importance of water to their health is a basic but important step. As I tell my patients, replacing water lost from perspiration and consumption of caffeine beverages is essential. Most patients are not aware that for every cup of coffee they consume the body requires a cup of water to re-hydrate. Staying hydrated doesn’t require the need to drink water all day. I often tell my patients that they can also absorb water by: • adding lemon, orange or mint to water • eating raw vegetables high in water content like cauliflower, cucumber, or spinach • making coconut water ice cubes (a natural sport drink), a formulation that has four times more potassium than a banana and is high in vitamin B.

Sugar I spend a considerable amount of time with my patients discussing sugar. The role of refined sugar consumption in our health is of-

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ORAL HYGIENE ten not well understood by patients. We all know the effects sugar has on our teeth and its role in decay. What’s less well known is the effect of sugar on the immune response. Dr. Linus Pauling, a Nobel Prize winning microbiologist, conducted famed work related to vitamin C and the common cold. In the same research he found that sugar severely slows down the ability of white blood cells to engulf bacteria. Over the thirty years since Dr. Pauling’s work many, scientists have continued on with the premise of his research. Dr. Steve Hickey of Johns Hopkins University states: “Glucose (sugar in its simplest form, as found in the blood stream) and vitamin C have a similar chemical structure. So similar, in fact, that when a white blood cell tries to pull in more vitamin C from the blood around it, glucose can get substituted by mistake. If the concentration of glucose in the blood goes beyond a certain concentration, the white blood cell’s 50-times vitamin C concentration can start to drop because of the large amount of glucose it’s pulling in as a substitute for vitamin C. In fact, at a blood sugar level of 120, the white blood cell’s ability to absorb and destroy viruses and bacteria is reduced by 75 percent. This blood sugar level would be easily obtained by any normal person eating some sugar (cake, cookies, candy, soda or even drinking fruit juice). Further, it can take four to six hours for the vitamin C concentration in the white blood cells to reach that optimum 50-times concentration again.”10 (Fig. 111) When I first learned about this research 11 years ago, I was inspired to make nutrition the focus of my periodontal therapy program. Too often I was seeing poor oral tissues with poor tissue integrity, with patients’ gums bleeding readily and profusely. Once I looked in depth at patients’ diets, I found consistent patterns of poor fruit and vegetable consumption and high levels of consumption of highly processed foods and refined sugar intake. These correlations were even more prevalent among diabetes patients because of the glucose in modulating vitamin C transport. When working with patients, I seek to make them aware that sugar consumption

impairs their immune system and, in itself, has no nutritional value to their bodies. In fact, the more sugar they eat, the greater the negative impact on their immune function, thereby limiting the support available to their oral health. “Refined sugar and simple sugar (sucrose, maltose, dextrose, corn syrup, honey, maple syrup, fructose, sucrose, high fructose corn syrup) in general place stress on our blood sugar and can significantly reduce the ability of WBC to destroy foreign particles and micro organisms.”12 The goal with patients who consume high levels of sugar is a) to introduce healthy sugar alternatives into their diets, b) educate them on the importance of whole foods and c) transition them to properly balanced meals and snacks combining protein, healthy fats and whole grains (ideally gluten-free grains when possible). Here are some meal examples:

Breakfast

½ cup steel cut oatmeal, ½ cup berries, a sprinkle of cinnamon, 1 tbsp almond butter, coffee (one milk or almond milk) or tea (green or white)

Lunch

Spinach and Arugula Salad (2 cups) with 3-5 ounce skinless grilled/roasted chicken breast. Add cucumbers, onions kale and other vegetables that you enjoy Salad dressing: ½ tbsp vinegar, ¼ lemon juice, ½ tbsp olive oil, pinch of salt, pepper and oregano or other herbs and spices you prefer.

Dinner

3 ounces grilled Salmon, steamed vegetables (1 cup either broccoli, asparagus, peppers, eggplant), ½ cup brown basmati rice, 1 cup green leafy salad dressing -olive oil, vinegar

Snacks • h igh-fibre carbohydrates, protein and healthy fats • example snacks • 1 small apple 1 tbsp almond butter • ¾ cup greek yogurt ½ berries • 1 cup applesauce with 10 almonds

November 2014

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ORAL HYGIENE

• 1 cup vegetables with 2 tbs hummus • 1 soft boiled egg with cut up vegetable • ¼ trail mix • ½ an avocado with hemp seeds on whole grain crackers

Sugar substitute options Stevia Succanet Coconut sugar and flour for baking Truvia Xylitol In my experience, as patients begin to reduce the amount of sugar in their diets, they often begin to feel more healthy. Their sense of improved health often inspires them to further improve their diets. As with water consumption, the key is for patients to take steps to reduce sugar intake so that they can gradually begin to better support their oral wellness through improved overall health.

Antioxidants /Phytonutrients

Patients who have achieved sufficient awareness to increase their water consumption and decrease their sugar intake may be open to enhancing their antioxidant intake. I highlight for these patients the importance of antioxidants in their diets. For many years, researchers have recognized that diets high in fruits and vegetables, legumes and whole grains, help to reduce the risk of a number of diseases. The reason these foods help to prevent diseases is because of the high antioxidant content. Dietary antioxidants include essential vitamins and minerals as well as phytochemicals that are present in plant food. “Antioxidants can prevent cancer-causing DNA damage, protect blood vessels against atherosclerosis, help optimize blood flow to the heart and brain, and protect the brain cells against oxidative death that lead to Alzheimer’s, Parkinson’s disease and other degenerative conditions that increase in age”.13 Antioxidants have the ability to protect the body from most diseases associated with inflammation. Our bodies produce very few antioxidants. Therefore it is imperative for our overall health, and its related support to our oral health, that we integrate these plant-based foods in our diet on a daily basis. Here are some of the best sources of high antioxidant foods/ superfoods that I advise my patients to consider:

Fruits: berries (strawberries, cranberries, blackberries, raspberries), kiwi, pineapple; Fresh Vegetables: leafy greens, artichoke, spouted greens, kale, spinach, broccoli, red peppers; Nuts and Seeds: almonds, pecans, walnuts, hazelnuts, hemp or chia seeds; Beverages: green tea, white tea, red tea; Spices: cinnamon, oregano, rosemary, tumeric, thyme; Legumes: red kidney beans, pinto beans, black beans.

Essential Fatty Acids and Omega-3 Fatty Acids Many patients are unaware of the importance of essential fatty acids, the building blocks of which fats and oils are composed. They are deemed essential because the body cannot manufacture them, therefore they need to come from our diet. Essential fatty acids improve skin and hair and aid in the transmission of nerve impulses. They are also necessary for normal brain development and functioning of the brain. Essential fatty acids are also used by the body for the production of prostaglandins (hormone like compounds made from essential fatty acids) that act as chemical messengers and regulators of various body processes. Omega-3 fatty acids are very important in the role of inflammatory diseases. “Investigations of diet and disease have highlighted an inverse relationship between ingestion of fish oil, which is high in n-3 polyunsaturated fatty acids, and the incidence of typical inflammatory diseases such as arthritis and coronary heart disease.”14 Furthermore, “Ingestion of n-3 polyunsaturated fatty acids, such as docosahexaenoic acid and eicosapentaenoic acid, results in their incorporation into membrane phospholipids, which can alter eicosanoid production after stimulation during the immune response. These eicosanoids promote a reduction in chronic inflammation, which has led to the proposal that fish oil is a possible factor.”15 I recommend the following sources of Omega-3 fatty acids to my patients:

Sources of Omega-3 Fatty Acids

Cold water fish: anchovy, salmon, mackerel, black cod, white fish, pacific sardines, herring, antartica krill oil

November 2014 www.oralhealthgroup.com

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1 Than a manual toothbrush. M. Ward, K. Argosino, W. Jenkins, J. Milleman, M. Nelson, S. Souza. Comparison of gingivitis and plaque reduction over time by Philips Sonicare FlexCare Platinum and a manual toothbrush. Data on file, 2013. 2 Defenbaugh J, Liu T, Souza S, Ward M, Jenkins W, Colgan P. Comparison of Plaque Removal by Sonicare FlexCare Platinum and Oral-B Professional Care 5000 with Smart Guide. Data on file, 2013. Single use study. © 2014 Philips Oral Healthcare, Inc. All rights reserved. PHILIPS and the Philips shield are trademarks of Koninklijke Philips N.V. Sonicare, the Sonicare logo, DiamondClean, FlexCare Platinum, FlexCare, FlexCare+, ProResults, Sonicare For Kids and AirFloss are trademarks of Philips Oral Healthcare.

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ORAL HYGIENE

Other food sources: Flax, walnuts, soybeans, tofu, brussel sprouts, cauliflower, winter squash.

nutrients. I recommend that my patients add the following foods to their diet to enhance the probiotics in their diet.

Probiotics

Food Sources of Probiotics

Finally, I also inform my patients about the importance of probiotics to their health. Probiotics are beneficial bacteria normally present in the digestive tract. The balance of good versus bad bacteria in the digestive tract is important for healthy digestion, a healthy immune system, vitamin and mineral absorption, assisting in digestion of protein, and synthesizing vitamin K. They also prevent the overgrowth of yeast and other pathogens. “Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Amongst the many benefits associated with the consumption of probiotics, modulation of the immune system has received the most attention.”16 Probiotics most often used in a supplement are form and bifidobacteria. Lactobacillus acidophilus is a type of friendly bacteria that assists in the digestion of proteins, a process in which lactic acid, hydrogen peroxide, enzymes, B vitamins, and antibiotic substances that inhibit pathofenic organisms are produced. Acidofilus has antifungal properties, helps to reduce blood cholesterol levels and aids in digestion, and aids in the absorption of

Yogurt, miso soup, sauerkraut, kefir, kombuchi, micro-algae (spirulina, chorella, blue algae added to a morning smoothie), pickles, tempeh (fermented probiotic), rich grain high in B12.

Bringing it All Together Not all patients will make all the necessary modifications to their diets immediately. For many it takes time. What’s most important is that they understand that their oral and overall wellness are inextricably linked and mutually reinforcing so that they have a sustained motivation to change their diets. For some patients I find that the food pyramid helps them bring it all together.

Food Pyramids Food pyramids are commonly used to teach individuals how to eat a healthy and balanced diet. There are no mandatory foods required by food pyramids. Rather a variety of choices are offered by food groups, and individuals can choose different foods from each food group to ensure they obtain all the nutrients their body needs. For example, nutrition experts commonly recommend eating a “rain-

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ORAL HYGIENE bow” of fruits and vegetables, because fruits and vegetables of different colors contain different vitamins, minerals and antioxidants (Fig. 217).

CLOSING I have advanced the view in this article that addressing periodontal disease is at the core of how we best serve our patients. Periodontal disease should be viewed by patients as clear evidence of immune distress in their bodies and treated as a priority issue in their overall health. Working to achieve patient awareness is a central means by which we can help our patients enhance their oral and overall wellness. As oral health care specialists we are well positioned for this challenge. After all, our work is centered around the prevention of disease and decay, including a sufficient focus on nutrition to allow us to serve our patients well. Perhaps what is not yet as present in our work as it might be is a more structured approach toward prevention from the holistic perspective I have described. We have the ability to organize our oral healthcare specialist teams around prevention, rooted in patient awareness. We could create nutrition modules for use in our practices. We could further embrace, as many of our patients do, one of the most rapidly growing fields in healthcare, alternative medicine, to develop modules to assist our patients in their paths toward optimal health. What I’m suggesting does not constitute a paradigm shift. As oral healthcare specialists we are on front lines of preventative healthcare. Prevention, after all, is a founding tenet of dental health care. What may be required for oral healthcare specialists to be as effective as we can in the future in serving our patients, is embracing the roots and fundamentals of our field in order to fully realize our future. n

REFERENCES 10. C haturvedi A, Engels E, Pfeiffer R et al. Human papillomavirus (HPV) and rising orophyaryngeal cancer incidence and survival in the United States. In: Program

and Abstracts of the 2011 American Society of Clinical Oncology Annual Meeting; June 3-7, 2011; Chicago, Abstract 5529. 11. C leveland J, Watson M, Wilson R, Saraiya M. Incidence of potentially human papillomavirus-associated cancers of the oropharynx in the U.S.,2004-2007. In: Program and Abstracts of the 2011 North American Central Cancer Registries Annual Meeting: June 21-24, 2011; Louisville, Ky. Abstract P-045. 12. Watson M, Saraiya M, Ahmed F, et al. Using population-based cancer registry data to assess the burden of human papillomarivur-associated cancers in the United Sates; overview of methods. Cancer 2008;113(10 suppl):2841-2854. 13. Gillison ML, Chaturvedi AK, Lowy DR. HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women. Cancer 2008;113(10 suppl):3036-3046. 14. C enters for Disease Control and Prevention. Human papillomavirus (HPV)-associated cancers: number of HPV-associated cancer cases per year. http://www.cdc. gov/cancer/hpv/statistics/cases.htm Accessed August 22, 2011. 15. Dayyani F, Etzel CJ, Liu M et al. Metaanalysis of the impact of human papillomavirus (HPV) on cancer risk and overall survivial in head and neck squamous cell carcinomas (HNSCC). Head Neck Oncol 2010; 2:15. 16. C leveland JL, Junger ML, Saraiya M et al. The connection between human papillomavirus and oropharyngeal squamous cell carcinomas in the United States. Implications for Dentistry. JADA 142(8): 2011; 915-924. 17. Newland JR, Meiller TF, Wynn RL, Crossley HL. Oral Soft Tissue Diseases: A Reference Manual for Diagnosis and Management. Lexi-Comp Dental Reference Library 2007;p. 101. 18. Newland JR, Meiller TF, Wynn RL, Crossley HL. Oral Soft Tissue Diseases: A Reference Manual for Diagnosis and Management. Lexi-Comp Dental Reference Library 2007;p. 103. 19. http://oralcancerfoundation.org/

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Healthy RECALL What Do Your Numbers Say?

Debra Engelhardt-Nash

Founding member of and served two terms as President of the Academy of Dental Management Consultants. She is currently the VicePresident/President Elect for that academy. She is an active member of the American Dental Assistants Association and serves on the Board of the American Dental Assistants Association Foundation. Debra is also a member of the American Academy of Dental Practice Administration. She has been repeatedly recognized by Dentistry Today as a Leader in Continuing Dental Education and in Dental Consulting.

here are some dental experts and consultants who consider hygiene a “loss leader” for the practice — necessary for patients’ dental health, and a new patient portal, but not an aggressive contributor to increasing practice productivity. But hygiene productivity has a significant impact on overall practice health and is a MAJOR contributing factor to practice growth. There are critical numbers to track when determining the fiscal fitness of your hygiene department. Assessing the health of this segment of your practice and fine-tuning its operations will significantly increase profitability. To ensure your hygiene department is operating productively and successfully, important statistics to monitor are below.

Numbers to track Most practice productivity is derived from 70 percent restorative production and 30 percent hygiene production. In practices with multiple hygiene providers, the percentages may vary by 10 percent or more. The benchmark goal for most offices is a three or four to one ratio of hygiene production to hygiene compensation. The hygienist should produce three to four times his or her daily compensation. If the hygienist is functioning as a new patient treatment coordinator full time, the daily productivity may be slightly lower. However, treatment acceptance from new patients would be credited to that hygienist’s productivity. It is important to be sure that all daily hygiene productivity has been recorded. Each hygienist should review their day sheet or patient routing slips at the end of each day to be certain that all charges were posted properly. One set of missed bitewing x-rays per day (at $95.00) equals a revenue loss of $19,00.00 annually (based on a 200 day year). One periapical (at $35.00) not posted 50 percent of the time equals an annual production loss of $3500.00. Were proper codes posted for the type of

procedure performed? Did the hygienist provide a periodontal maintenance treatment and was a standard prophy code used? Did a scheduled prophylaxis appointment become a periodontal therapy appointment? Was changing the procedure code overlooked and the appropriate fees not billed? Was Arestin™ placed and not recorded? These are common errors or omissions in posting that can affect the end of day production report. Spending a few moments at the end of the day to review posted treatment and charges for the day will ensure all procedures were accurately posted and billed. The hygienist should sign the copy of his or her day sheet after reviewing their schedule and charges and remit to the billings manager or financial coordinator.

Lost hygiene appointments Unfilled hygiene time is important to track. If hygiene productivity seems lower, it may be due to open hygiene time. One or two lost appointments here and there may not seem significant to overall productivity, but let’s do the math: One lost hygiene appointment per day based on average appointment charge of $245.00 x 200 hygiene days in the practice — 245.00 x 200 days = $49,000.00 annual loss. Calculate your unfilled hygiene time and you may find a cause to review the mechanics of your continuing care program or need to refresh your communication skills to keep the schedule filled. Obvious exceptions to note would be illness, weather related office closures, or interrupted days due to mechanical failures.

Additional treatment diagnosed and accepted from continuing care patients This is a major source of additional treatment revenue for the practice. It is important to assess how well your office is doing at converting incomplete treatment or new treatment findings into treatment acceptance.

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ORAL HYGIENE In addition to being skilled clinicians, dental hygienists must possess good communication skills in order to motivate and satisfy patients, and offer cutting-edge treatment options. Patients today are not only looking to establish relationships with providers (dentists and dental hygienists), but they are also sophisticated enough to assess a clinician’s skills. Patients who find hygiene-therapists whom they can trust feel more comfortable establishing compliance with appropriate recall appointments and treatment options. A review of any treatment recommendations not completed prior to the recare appointment is the responsibility of the hygienist. A conversation about this care should be initiated at the beginning of the recare visit. “Tell me what has prevented you from completing this treatment?” is a good way to reintroduce previous treatment recommendations during continuing care appointments. Allow time for conversation during recall visits and additional treatments diagnosed and accepted from continuing care patients will likely increase. The continuing care appointment is also the ideal time to let existing patients know about new treatment modalities in our office introducing new treatment options Visual aids are extremely helpful. Many software products offer multi-media learning modules to aid in educating patients during office visits as well as linking them to the practice website for viewing. “Chat-and-polish” dental hygienists should be obsolete by now, but there are plenty, and they may be keeping your daily hygiene productivity and your treatment acceptance rate low. Discussing treatment possibilities during recare visits is not optional but required.

Recall return rate Simply because a hygiene schedule appears busy doesn’t mean that the practice is seeing the majority of its patients on a routine basis. The hygiene schedule may be full of the same

people over and over again — at a less than desirable retention rate. This may give the practice a false sense of a high percentage of returning patients. Every office should expect a minimum of 80 to 85 percent recall return rate in their practice. This means that 80 to 85 percent of active patients (patients seen within the last 18-24 months) are scheduled for continuing care. Exceptions to this may be practices in a transient area of expected high population turnover, such as college or military communities. What percentage of active patients are returning for care? Determine how many active patients are currently in the practice. Determine your goal for returning patients. Eighty five to ninety percent return is a reasonable objective for a healthy recall return rate. Calculate the average frequency you see patients. Twice yearly is a basic average, but your office may choose to factor a bit higher occurrence to allot for periodontal maintenance patients who are seen three or four times per year. Two and one half or three times per year may be a more accurate frequency rate. Next, multiply the number of active patients by the desired percentage of patients you would like to see annually. Multiply that total by the average number of times you will see these patients throughout the year This will be the number of visits required to meet your patient retention objectives. Divide that number by the average number of patients seen per day to determine how many hygiene days your office will need annually to reach your goal. Another way to calculate your recall retention rate is to count the number of hygiene days currently scheduled and determine the average number of patients seen per day. Establish an average number of hygiene appointments available per year and divide by 85 to 90 percent of the active patient base. Continued on page 34

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CASE STUDY 6

Changing the value clients place on visits.

is that gienists face y h l ta n e d s ns. e ommendatio est challeng c g re ig b e n e ie th g f y o h One nts ly with oral use many clie lways comp a a c e ’t n b o g d n ts ro n clie eed to be st tation skills n n se re p se a ease. C ey have a dis th r a e h to t don’t wan

ISSUE

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SOLUTION

RESULTS

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patie shifts to the ip h rs e n w o ence, when rval. In my experi mended inte m o c re ir e th n 80% come o

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ORAL HYGIENE

The ‘Dental Hygiene Experience’ BREAKTHROUGH BLUEPRINT — Part I of a III Part Series Kathleen Bokrossy, RDH

Founder of rdhu and Meet Me In The Boardroom Committed to Transforming the Dental Hygiene Experience www.rdhu.ca www.meetmeintheboardroom.com For your free business growth guide visit: www.rdhu.ca/ freebusinessgrowthguide

8 Simple Secrets to Growing a Successful Practice!

e all know and appreciate that the dental hygiene department is the pulse of any dental practice. Whether you have your own dental hygiene practice/business or are working within a practice where you are actively involved in the plans to grow and build the practice (the ‘intrepreneur’), it is essential that you know how to attract more clients, how to ‘wow’ them while they are in your care, and how to get them to refer you to their friends and family. Many dental practices look at their business as a single event, the appointment. Insufficient thought and effort is made figuring out how to attract new clients, how to manage the client’s experience while in your care and the things you can be actively doing to encourage them to recommend you to their friends and family. We all know that word of mouth is the best way to grow any business, there’s lots we can all be doing to spread the word about the good work that we do. With no real plan in place on how to get clients in the door and turn them into raving fans, most dental practices struggle to find and keep the number of clients they are looking for. By not putting systems in place that can repeatedly attract new clients, many offices make random attempts hoping something will work. They may put some ads in the local paper or Yellow Pages, perhaps be a part of a community event or participate in a postcard mailer, hoping that the phone will start ringing and that the client will choose their prac-

tice over the two across the street. By not developing a strategy and system that focuses on who are you trying to attract, what you can do within the practice to make their experience a positive and memorable one and what you can do after they leave so that they are likely to refer you, offices are missing a tremendous opportunity. In order to have any successful business, whether it is a chiropractic practice, a small plumbing business or a dental or dental hygiene practice, best business practices and systems need to be put in place in order to achieve maximum results. We often don’t think of running a dental practice as a small business, where sales have to take place in order for everyone to take home a paycheck. However, it is a small business and we have to pay attention to our customers (our clients) and be in tune with the sales, revenue and expenses of the practice. An important system to apply to your practice is firstly, looking at your practice as three separate components or even as three separate businesses, if you will! The first component is all about finding your clients and compelling them to get in touch with you. This is probably the most difficult component of the system and you need to pay a lot of attention to this. The second component is all about what goes on whenever the client is in contact with your office. From the first phone call, to the ease of them finding you, to the first impression as they walk up to your practice and

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Because everyone needs us, we try to attract everybody and as a result we often don’t really attract anybody! open the door, all the way until the appointment is complete. The third component is a very important one and one that gets ignored more times than not. What happens after the client leaves is typically, the client doesn’t hear from you until it is time for their next re-care appointment. This is a big mistake and missed opportunity. All of these components need to be treated separately and not blended as one. One person should be working on the ‘before’ and ‘after’ experience only and not be taken off this essential aspect of the business, if you are committed to transforming your dental practice. Applying these strategies to your existing practice will not only bring you fiscal results, but it will also revive your team and help get everyone on board and excited. So often we get busy in our day to day responsibilities and we don’t take the time to reflect and work on our businesses instead of just in our businesses.

BEING ATTRACTIVE: The process of attracting new clients (Secrets #1-4)

Secret #1: Choosing a Single Ideal Client Profile One Client at a Time As dental professionals, we know that EVERYBODY would benefit from regular dental visits. But to be truly “attractive” you need to stand out from the crowd by appeal-

ing to only one individual type of client. That means you need to communicate that you understand and are committed to serving that individual’s unique needs. People need to feel that they are being understood and that the reason to use your services is that you understand them and what they specifically need. Secret #1 is all about selecting a very specific group of people that you will build your Attraction Campaign around. This is one of the most important aspects of creating a successful marketing campaign but is so often forgotten. Because everyone needs us, we try to attract everybody and as a result we often don’t really attract anybody! We begin to look like every other dental office and the clients’ decision is based purely on convenience or location. It just doesn’t work to try to send one global message and hope it attracts everybody! This doesn’t mean that you can only work with one client type. What this means is that you will select a particular client type one client type at a time. To be attractive, you need to build your Attraction process one specific group at a time. Know exactly who your ideal client is for that particular Attraction campaign. Understand their needs, concerns and frustrations. Make sure you send a message out as though you are speaking to that one specific individual. They will pick up or read your message and think “Hey, they are talking to me”. Real attraction occurs when an individual feels that they are being understood or

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Offer free educational resources that speak to the worries and/or concerns of your potential clients that someone has what they want. Here are a few examples of a Single Ideal Client Profile where they will have unique and different needs: • Someone with teeth sensitivity to cold or hot and but doesn’t know what to do about it; • Someone with stained or yellow teeth, is self-conscious about it and wants white teeth; • Someone with bad breath (or knows someone with bad breath) embarrassed to talk to anyone about it. Each one of these potential clients will have different needs. Your job is to pique their interest by communicating how well you understand and can address their problem.

Secret #2: Being Attractive: Compel Your Potential Clients to Raise Their Hand If someone at the time is reading your message about tooth sensitivity and thinking about how they wish they could enjoy ice cream again, they will resonate with your campaign that specifically focuses on teeth sensitivity. It will make them notice your message and if you make it easy, they will ‘raise their hand’, letting you know that they are interested. By offering something to this particular client type that speaks to what they are specifically concerned about, they will feel compelled to get in touch with you. Offer free educational resources that speak to the worries and/or concerns of your potential clients. The best way to get their attention is to offer a no-risk way to learn more about their con-

cern. If they care enough about an issue to request information, you know that they are part of your potential client group. By offering free education or something that you can do to help them, you are demonstrating that you understand their unique needs. For instance: “Visit ------- for a FREE information guide on what causes tooth sensitivity to temperature and what you can do about it.” It needs to be something that gets their attention. Something that speaks to the person concerned with the issue. Something that gets them to ‘raise their hand’ so that you know this person is interested about this issue. By providing that person with important unbiased information about the topic, you get instant credibility in the client’s mind. You are positioning yourself as having expertise in this field and because you gave good valuable information to the client for free, you are beginning to build some goodwill. You are starting to make yourself stand out from the crowd! Ok, so you have gotten your dental practice to stand out from the crowd by offering great information specifically targeted at clients that have specific needs or concern. You have been able to get those clients to “raise their hand” by requesting some great targeted information from you. You now know who they are… what’s next? Well, that’s secret Number 3, which I look forward to diving into in our next article (Feb. 2015). n

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Not Just Different. Better. Common Cases and Recommended Treatment Range Spacing

Too much space between teeth up to < 2.5mm

Crowding

Not enough space between teeth up to < 4.0mm Per Arch

Midline Discrepancy

Teeth off center up to < 2.0mm

Tipping

Teeth tip outward or inward up to < 3.0mm per tooth

Rotation Teeth are turned < 45°

Intrusion/ Extrusion

Teeth sit too high or too low up to < 2.5mm

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ORAL HYGIENE

The Hygiene Department Lifeblood of the Dental Practice Cathy Jameson, PhD

Founder of Jameson Management, Inc, an international dental consulting firm focusing on all marketing, hygiene and management systems that lead a dental practice to increased productivity and profitability while decreasing stress. Dr. Jameson and Dr. Linda Greenwall of the UK have recently released the book, Success Strategies for the Aesthetic Dental Practice, published by Quintessence. The book can be purchased by contacting quintpub. com. or info@ jamesonmanagement. com or amazon.com.

eople aren’t aware of what is available in dentistry today. It’s the responsibility of dental professionals to offer that education — and no one is better to do this than the hygienist. Without question, the hygienist and the hygiene department have a major responsibility to help people get healthy, stay healthy, and preserve their restorations. In addition, the hygienist adds value to patient care by building and retaining relationships, educating patients about what is going on in their mouths, and by introducing new opportunities.

through traditional mail or through digital format, include an informative letter and a brochure about one particular treatment option that is relevant to the patient’s needs or history. Your excellent record keeping will help you to individualize your marketing or patient education efforts. Certainly, in today’s digital world, using emails, e-newsletters, or texts to send these messages makes good sense.

Patient Education

If you want to promote a certain type of treatment or a particular procedure, consider sending a letter and a brochure about it to your entire patient family. You could do this with traditional mailing or digitally. You could also do this through a series of large postcards. When patients are coming in for their hygiene appointment, the hygienist can ask if they received the information and if they are interested in seeing photographs or if they have any questions. Social media is here. Assign a person in your office to be the social media specialist. They would be responsible for reading your social media every day and answering any questions, etc. They would also need to post between three to five times per week. Some of the posts would be educational and some would be personal interest posts about you or your team (Clark, 2014).

In surveys conducted throughout the US (Jameson, 2000) patient education was rated as a desired area of improvement. Team members realize how important patient education is to both the patient and the practice, but feel they could do better at this. Because of the repetitive nature of hygiene appointments, the hygienist has a wonderful opportunity to educate patients about the following five things: 1. W hat has been diagnosed but remains incomplete; 2. New areas of concern since the last appointment that she/he will be bringing to the doctor’s attention; 3. Periodontal concerns; 4. Benefits of advanced restorative treatment; 5. O pportunities for aesthetic alterations. Here are some ways that the hygienist or the assistant can enhance patient education about the above five mentioned areas:

Marketing or practice building

When sending hygiene notices, whether

Send brochures to all patients – Use Social Media

The art of your dentistry Decorate your office with beautiful examples of your dentistry. Have your patients professionally photographed. Matte and frame the

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ORAL HYGIENE ©Deklofenak/Getty Images/iStockphoto

photographs and have them adorning your office. Have people be thinking about excellent dentistry throughout their time with you.

The best visual aid: photography Photography is the very best educational tool. As you know, there is nothing more impactful than a patient seeing their own mouth/teeth and seeing the possibilities of restoration or beautifying their smile through the use of photography. Design each and every hygiene appointment so that photography is a part of it. You may find that you schedule more dentistry out of each and every day than you are doing most any day. Education is the key. Organize your hygiene appointments to include the taking or review of photographs showing: • dentistry diagnosed but incomplete; • new areas of concern since the last appointment; • periodontal concerns; • a reas where advanced restorative care would be beneficial; • v iews that show their present smile, to talk about (or show them) what can be done through aesthetic alteration; Your cameras and photography are your most important diagnostic and educational tools. Approximately 83 percent of learning takes place visually.

Digital patient education programs Patient education programs can be provided on your computer monitors or on an iPad. Download patient education programs that are relevant to you and show these to patients at their hygiene appointments. Again, the programs can illustrate the five areas for potential growth previously outlined.

The Hygienist’s Role as Educator The hygienist has much to do during each and every appointment. However, nothing is more important than her/his role as educator. Approximately 40 to 60 percent of all restorative or aesthetic dentistry will come right out of the hygiene area. But in order for that to happen, the hygiene appointments must be carefully organized for both efficiency and effectiveness. In addition, the hygienist must see this role as valuable and be willing to provide exceptional education. There will need to be time invested in teaching the hygienist how to take outstanding photographs, how to educate people, how to ask questions and listen, and how to overcome objections that may be presented. All of this takes time, effort and willingness.

The Systems of Your Practice: Including your hygiene system

“The success of your dental practice is in direct proportion to the success of your sys-

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Determine how you will incorporate visual aids into each appointment in order to get the dentistry out of the charts and into the mouths of your patients tems.” (Jameson, 2010) According to Webster, synonyms for “system” are organization, arrangement, structure, coordination, method, and orderliness.” Follow these three steps in order to develop quality systems in your practice: • Set up the system; • Educate people to administer the system effectively; • Monitor the results you are obtaining to make sure that the system is working well and that the people on your team are working that system accurately and consistently. Go through each hygiene appointment and look for areas where you could be more efficient and more effective, always paying close attention to time management. Add in time for taking and reviewing photography. Determine how you will incorporate visual aids into each appointment in order to get the dentistry out of the charts and into the mouths of your patients. Make sure that all of the hygienists on your team agree on the system and that they also agree to implement the system in the same way. Include time in each appointment for patient education about home therapy or cotherapy and new opportunities for treatment. The appointment, of course, includes the doctor’s periodic oral evaluation. This is a valuable time in the relationship to the patient. The purpose of the periodic oral evaluation is to do the following: • Reevaluate • Reeducate • Remotivate

Dentist performing hygiene evaluation

Doctors, one of the most important appointments you provide throughout each and every day is your periodic oral evaluation. It is at this appointment that you diagnose and recommend treatment on new ar-

eas of concern and reinforce the importance of proceeding with the next phase of diagnosed dentistry that has not been completed. It is also the appointment where you can introduce people to new options, like advanced restorative or aesthetic opportunities. It is critical during this appointment that the dentist and the hygienist have what we call “linkage communication” where support from one to the other is evident. Do not short change your patient, your hygienist, or yourself by rushing through this appointment.

In Summary Most practices have more dentistry sitting in their charts waiting to be done than they will do in any given year. Give your patient and your practice the opportunity to get the dentistry out of the charts and into the mouths of the patients by enriching your hygienist and supporting her role as patient educator. You, your hygienist, your patients, and your practice will all benefit. n

REFERENCES 1. C lark, M. (2014). Creating Your Own Sales Force. Dental Economics. Pennwell Publishers: Tulsa, OK. Vol. 9. P. 98. 2. Jameson C. Controlling Stress in the Dental Profession Through Effective Communication. Oklahoma City, OK: JC Educational Services, 2000. 3. Jameson C. The Impact of Training in Transformational Leadership on the Productivity of a Dental Practice (unpublished doctoral dissertation). Minneapolis, MN: Walden University, 2010 Jameson C. The Impact of Training in Transformational Leadership on the Productivity of a Dental Practice (unpublished doctoral dissertation). Minneapolis, MN: Walden University, 2010

November 2014 www.oralhealthgroup.com

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E H T T H L I L N A G F O YOUR PATIENTS S MAY TAKE TO BED

THEIR DENTURES SHOULDN’T BE ONE OF THEM. 1-5

Though your patients may take comfort in keeping their dentures in at night, the consequences can be severe, from increased odour to fungal infections to increased caries.1–5 Guiding your patients through the best nighttime routine could be one of the most important conversations you have with them. That means removal and gentle, antibacterial cleaning with Polident®.6

1. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil. 1997;24(6):468–472. 2. Emami E, de Grandmont P, Rompré PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res.2008;87(5):440–444. 3. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(1):51–59. 4. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J. 1979;147(10):267–272. 5. Compagnoni Ma, Souza RF, Marra J, et al. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil. 2007;34(8):600–605. 6. GSK data on file, 2011.

TM/ or licensed GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4

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BREAKING THE CYCLE harder to let loved ones see them like that. Even when they are sleeping, many of them are more comfortable wearing their dentures. This feeling can get in the way of making the right decisions for their oral health. Patients can end up ignoring the nightly routines that are critical to ensuring proper dental health – namely, taking out their partial denture at night and letting it soak in a denture cleansing solution.

hen a patient with partial dentures is in your chair, you may not get the opportunity to find out why and how they ended up with dentures. You might not have the time to talk to them about how their dentures make them feel, and the reasons why they may not keep up with proper denture care. But, you are the one who can help them break the cycle of poor dental hygiene. When feelings conflict with dental care For patients who wear partial dentures, there is often a feeling of embarrassment that comes with it, which compromises their desire to smile, laugh, and self-confidence.1 Their dentures give them a sense of security and “normalness.” They are more comfortable wearing their dentures. It goes beyond being out in public – it’s 24 hours a day. It can be hard to look at themselves in the mirror without them, and even

Decreased saliva and airflow

Increased bacteria and fungi

difference in the lives of these patients. You are the compassionate voice at a place they may dread going. You are the one who can counsel these patients on the importance of a proper nightly routine, which includes soaking partial dentures in Polident®.

Embarassment and shame

Oral health issues

4 4

OF POOR DENTURE HYGIENE

Ignoring proper oral hygiene

Oral health at night At night, the mouth produces less saliva. Saliva is a key part of a healthy mouth, by helping protect teeth from decay and controlling bacteria and fungi in the mouth.2 When dentures are left in overnight, they can accumulate bacteria and fungi, which in turn can lead to mouth odour, fungal infections, and dental caries.3-7 Dentures should be removed for at least 3 hours, but overnight is best.8 Dental hygienists – The front line of oral health As a dental hygienist, you are in a position where you can make a

Oral health is a factor in quality of life Oral health is an integral part of general health and well-being. 9 Polident®’s formula improves oral health for denture wearers by penetrating the biofilm and killing 99.9% of odour-causing bacteria and other microorganisms that can cause oral problems.*10,11 Unlike a toothpaste, Polident® is non-abrasive and doesn’t create scratches, which can lead to microbial colonisation.10 In addition to helping keep dentures feeling fresh, a clean denture helps reduce the risk of gum irritation and soreness.11 Taking the time to counsel your patients on Polident® may make all the difference between maintaining their quality of life and losing more of it.

He lp yo u r p ar t i a l de ntu re pati e nts bre a k th e cyc l e o f po o r de ntu re hygi en e w it h Po l i de nt®. H e l p th e m h o l d o n to th e i r qu a l i ty o f l i fe. * In vitro single species plaque biofilm after 5-minute soak. References: 1. Trulsson U, et al. Edentulousness and oral rehabilitation: experiences from the patients’ perspective. Eur J Oral Sci. 2002 Dec;110(6):41724. 2. National Institute of Dental and Craniofacial Research. Dry Mouth. http://www.nidcr.nih.gov/oralhealth/Topics/DryMouth/Documents/DryMouth.pdf. Accessed July 25, 2014. 3. Emami E, de Grandmont P, Rompre PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res 2008;87(5):440-444. 4. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil 1997;24(6):468-472. 5. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95(1):51-59. 6. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J 1979;147(10):267-272. 7. Compagnoni MA, Souza RF, Marra J, Pero AC, Barbosa DB. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil 2007;34(8):600-605. 8. Halton Region. Denture Care. www.halton.ca/common/pages/UserFile.aspx?fileId=100069. Accessed August 19, 2014. 9. World Health Organization. Oral Health. http://www.who.int/oral_health/objectives/en/. Accessed July 25, 2014. 10. GSK Data on file, Lux R, 2012. 11. GSK Data on file, CSS MFC51013, 2014.

™ /® or licensed GlaxoSmithKline Consumer Healthcare Inc. Mississauga, Ontario L5N 6L4

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SYMPOSIUM REPORT

l a u n n 38 A th

International Symposium on Aesthetic Dentistry

he American Society for Dental Aesthetics hosted the 38th Annual International Symposium on Aesthetic Dentistry from October 22-25, 2014, in Baltimore, Maryland. The four-day conference is known for being dynamic. Although they are small in size, the ASDA boast an impressive number of industry leaders who attend and conduct workshops. In fact, about a third of conference attendees are recognized

32â&#x20AC;&#x192;

industry experts. Hands-on workshops are designed to maximize learning and information retention. The Lifetime Achievement Awards were presented at The Samuel D. Harris National Dental Museum, an affiliate of the Smithsonian Institute, on October 24th. The Lifetime Achievement Awards were presented to Dr. Paul Belvedere and Dr. Robert Weller. A Father of Aesthetic Dentistry Award Presentation was also held for Dr. Irwin Smigel. n

November 2014 www.oralhealthgroup.com

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SYMPOSIUM REPORT

n workmaximize ention. Awards muel D. eum, an nstitute, Lifetime resented r. Robert tic Denwas also

November 2014â&#x20AC;&#x192;

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PRODUCT PROFILE

PETSMILE Recommended by the Veterinary Oral Health Council for plaque inhibition, Petsmile Professional Pet Tooth paste is the gentle and safe way to clean your dogs’ teeth and gums. Naturally beef-flavoured Petsmile works on contact to dissolve the protein pellicle, resulting in a heathier, cleaner mouth.

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SUPERSMILE® CRYSTAL COLLECTION TOOTHBRUSHES Supersmile® Crystal Collection Toothbrushes feature a slim, lengthened Lucite handle, ergonomically shaped with a series of indentations to guide hand-positioning to the ADA-recommended 45 degree brushing angle, as well as five tufted rows of soft, rounded nylon bristles. The Collection reaches beneath the gum-line where plaque accumulates and causes decay. A flat bottom also enables each brush to stand upright for hygienic drying. www.supersmile.com BIOTÈNE® The new Biotène® spray provides instant moisturization and helps to freshen breath. The spray gives comfort and relief from dryness and is great to use during the day or on the go, anytime, anywhere.

www.biotene.com SUPERSMILE® PROFESSIONAL WHITENING FLOSS Supersmile® Professional Whitening Floss is the only floss that provides clinically proven whitening benefits. The Whitening Floss uses an unwaxed nylon thread to reduce chances of splitting between tight teeth, while ensuring the tiniest spots of plaque are reached. It is impregnated with CALPROX®, Supersmile’s proprietary form of calcium-peroxide, to help whiten hard-toreach areas between teeth, while baking soda helps freshen breath and maintain healthy gums.

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Continued from page 19

Example:

• 2 hygienists working 4 days per week = 8 days per week x 50 weeks = 400 days • 8 patients per day x 400 days = 3200 • 3200 appointments. / 2.5 visits per patient = 1280 patients / 2000 active patients = 64% Recall Return Rate — too low!

If 1700 patients appointed and only 10 percent appointed for additional dentistry averaging 800.00, $136,000.00 additional treatment production would be realized from hygiene. If the office is not maintaining 85 to 90 percent of patients returning for continuing care it may be due to these factors: •N ot enough hygiene days available to meet practice needs • Too much unfilled hygiene time • Transient demographics • L ack of recare system • Poor scheduling • None or poor patient tracking • I neffective patient communication skills

Loyalty = profitability Increased customer loyalty is the single most important driver of long-term profitability. Retaining five percent more of your patients can boost profitability as much as 95 percent. An increase in patient loyalty of five percent can deliver 95 percent greater profitability over the lifetime of the patient. And retaining patients is not only less expensive, but existing loyal patients are ready to accept treatment more readily. They generate positive word of mouth and referrals and are less likely to defect for “discounts”.

Stay on track The hygiene department of a dental practice is becoming more sophisticated and complex in services provided, which maximizes operational performance and productivity quotas. Know your numbers and assess the effectiveness of your continuing care program. If your hygiene department is less than ideal, develop core competencies and coach the hygiene team to reach these goals. Stretch and grow your practice to unprecedented heights and watch your dental hygiene profits break new records. n

November 2014 www.oralhealthgroup.com

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DENTAL MARKETPLACE

ASSOCIATESHIPS

PRACTICES & OFFICES

CALGARY, AB

Calgary practice for sale. Located on top floor of professional building. The clinic is long established with a wonderful team of experienced staff. Valuation report prepared by highly reputable Calgary appraiser is available. Please call 403-836-5088 or e-mail: dentrixfielding@yahoo.ca

NORTHERN LAKE SUPERIOR, ON Three family practices available in Marathon, Terrace Bay, White River. Extremely low overhead, unlimited work, above average net revenues. Call in confidence 807-228-1234.

TORONTO, ON

Professional space for sale at 600 Sherbourne Street. Asking $148.000.00 reasonable maintenance and taxes runs like rent. Around 540 sq. ft. Overlooking the ravine at the subway. Available Dec 1st. Tel: 416-966-0300.

GREATER VANCOUVER, BC

Large and very well established general practice for sale in South Surrey, Panorama Ridge — a desirable and growing neighbourhood. Beautiful new hi tech facility in new building, completely digital and paperless, solid lease, 5 modern ops, loyal staff, >2300 ACTIVE patients. High Gross, high net — enough for two FT dentists. Reply to Oral Hygiene Box 25 — e-mail: kshaw@oralhealthgroup.com

OTTAWA, ON

Office space for lease in a beautiful commercial plaza in Ottawa,on major highway, ~2000 sq ft, ample parking, perfect for dental GP or specialist. Tel: 613-799-5683, or email: c4ottawa@gmail.com

ASSOCIATESHIPS Full time associate dentist needed for busy, modern established practice in Toronto. Complete range of services provided including orthodontics, periodontics, implants, laser dentistry, digital impressions, oral surgery and conscious sedation. An excellent opportunity for professional development concurrent with competitive income. Call: 416-748-3353 or 1-866-866-8437.

ASSOCIATES FOR HAMILTON & WATERLOO, ON

Associates required, for TWO VERY busy and modern practices with VERY strong new patient flow. E-mail: associatedentist@ymail.com Fax CV: 888-880-4024

LONDON, ON (and surrounding area) Dove Dental Centres is looking for full time associates for their progressive, modern, multi-location group of dental practices in London, Ontario and surrounding area. Interested candidates should forward resume and cover letter to: dovedental@ody.ca

KINGSTON, ON

Full time associate required for large group practice in well established office in new building. Modern, digital, paperless office in growing part of beautiful Kingston. Please contact: lorrie@cataraquidental.com

EDMONTON, AB Looking for an associate (part/full time) to join our group of multidisciplinary practices which are focused on the highest quality of patient care and using the latest technology available. We are looking for a self-motivated, high-energy, clinically strong candidate who is interested in learning and continuing education. This is a great opportunity for the right candidate to grow with our expanding group and to work in a great environment. Buy-in opportunities are also available for the long-term associates. If you are interested, please email your CV in confidence to edmontondentalcareer@gmail.com

www.oralhealthgroup.com

OHYNov14 p37-38 Classifieds.indd 37

www.oralhealthgroup.com

TORONTO, ON

DENTAL MARKETPLACE

Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthgroup.com Toll free: CDA 1-800-268-7742, ext 6770 • Toll free: USA 1-800-387-0273, ext. 6770

TORONTO, ON

Part-time associate for downtown practice. Must be interested in all disciplines of dentistry and have comprehensive continuing education. E-mail resume to: tooth_fixer@yahoo.com

EXCELLENT ASSOCIATE OPPORTUNITY ONE HOUR NORTH EAST OF TORONTO Busy dental office looking for full or part time associate. One evening weekly and no weekends. New graduates welcome. For info please call 705-324-7150 E-mail: lindsayfamilydentistry@gmail.com

GRANDE PRAIRIE, AB

Three full time associates needed for our well established family practices, with travel to our satellite clinic in High Prairie, AB. Present associates will be leaving end of July 2014. Very busy practice with above average remuneration. Please email drroy04@telus.net if interested.

PETERBOROUGH AND OAKVILLE, ON

There is an immediate opening for the right associate in the Peterborough and Oakville areas. The candidate must have excellent communication skills with staff and patients. Experience is preferred, but new grads are welcome to apply. Please submit your C.V. to sandie@dentalofficeconsulting.com

AJAX, ON

PART TIME ASSOCIATE FOR A FAMILY PRACTICE We are looking for a personable, compassionate associate who can provide high quality dentistry to our modern, high-tech office. Must have a minimum of 3 years experience in a private dental office setting. Candidate should be available Tuesday evenings, Thursdays and 2 Saturdays a month. Please send resumes in confidence to: Theresa.dentinajax@gmail.com

HALIFAX, NS

Located in Halifax, Nova Scotia. An experienced Dentist is needed to join a great team of a high volume clinic. As a bonus we offer a profit sharing formula based on overall clinic performance. Be busy the moment you start! Contact info@finetouchatlantic.com or call (902) 835-4222 ext. 223

November 2014

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OTTAWA, ON

DENTAL MARKETPLACE

ASSOCIATE NEEDED We have a thriving practice in Ottawa and we need an associate’s help. We are creating a great opportunity for someone who wants to treat people in a fun and caring environment. Please send your resume to dynamic.dentist.2014@gmail.com

THOMPSON, MANITOBA

Full-time, energetic, detail oriented associate needed immediately for established, busy family practice with income potential up to $30,000 per month. Enjoy a fully booked schedule and ability to reach your goals as a dental professional. Experience preferred. Excellent opportunity. New grads welcome. Living and Travel Accommodations provided. E-mail cv: thompsondent@gmail.com Fax (204) 677-4072, Ph: (204) 939-0083.

BELLEVILLE, ON Full time Associate needed in Belleville Small well established practice, looking for a full time associate dentist to take over owners schedule. Candidate should have strong communication skills and be proficient in all aspects of dentistry. Please contact Trish at clinicaldirector157@gmail.com

EAR FALLS, ON

Locum dentist needed from January 23/15 to March 5/15. Prefer dentist who would consider associate opportunity in the future. Accomodations provided at no charge next to the dental office in Ear Falls, plaza and three restaurants nearby, 400km from Winnipeg, 45% of gross billings. Send resume to Dr. Matthew Walkiewicz at e-mail: mattjw@kmts.ca

TRENTON, ON

We are looking for a motivated dentist who enjoys all aspects of dentistry. Come work in a busy, state of the art facility with new technologies. We have an excellent and very friendly team and looking for the right fit to join our practice . Please email us at ryounes@sympatico.ca EAST OF TORONTO, ON

Experienced friendly oral surgeon and endodontist required for busy dental practice in east of Toronto. Please forward resume to: glenannadental@rogers.com Fax: 905-831-5975

November 2014

OHYNov14 p37-38 Classifieds.indd 38

NORTHERN ONTARIO FULL TIME ASSOCIATE WANTED

Well established busy practice 30 years, poised for growth!!! Remuneration package $20K-$25K per month range. Long standing, cheerful, professional, staff. Experience northern hospitality and nature at her best. Graduates and Experienced Dentists welcome. To book your interview please e-mail resumes to: nor_dent@hotmail.com

ASSOCIATE OPPORTUNITY

Tillsonburg (35 min SE of London) and Stratford (30 min W of Kitchener), Ontario Full time (Tilllsonburg) and Part time (Stratford) available. Busy and established offices. Modern, fully paperless/ digital, new equipment and leading edge technologies (cerec, lasers, implants...). Interested candidates please mail: dentalgroupswo@gmail.com

ORANGEVILLE, ON

Established Orangeville office seeking a part time experienced associate (at least 2 yrs). One evening per week and one Saturday a month. E-mail resumes to Progressivedental16@hotmail.com

TORONTO, ON

HTL Dental seeking a motivated, personable team player as an associate to join our current three modern and progressive practices in Scarborough, Markham and Richmond Hill. New practice soon to open up in North York. Part time leading to Full time position. Candidate must have excellent clinical and communication skills with a friendly personality. If interested in exploring further, please send cover letter and CV to: jobsteeth@gmail.com

VANCOUVER ISLAND, BC

We are looking for an Associate for our Cumberland Practice. Cumberland is located on Vancouver Island in the Comox Valley. Dr. Lathangue owns several practices on the Island and is looking for exceptional people to join his team. You must be knowledgeable in all aspects of dentistry and be dedicated to patient care. Email resumes to: joan@dogwooddental.com

DRYDEN, ON

Looking for a motivated full time associate for January 2015. Earn 50% in a friendly efficient environment with fully trained staff and a well established patient base. Will help associate with accommodation and getting settled in Dryden. Experience desirable but not a must. Associate must be dedicated to patient care and clinical quality. Please email your resume to Dr. Ghada Ibrahim at vivadental@hotmail.com

MUSKOKA, ON

Are you professionally fulfilled? Are you practicing dentistry in fertile soil and at the level you desire? Fantastic career and lifestyle opportunity! Don’t hope any longer. Come share your passion and enthusiasm for dentistry with a connected like-minded highly trained team! We are looking for an associate who enjoys people and loves dentistry Our thriving modern high tech family practice requires a GP who is confident with a strong clinical skills-set. We are in Ontario’s playground where you can exceed your professional goals while enjoying a lifestyle desired by many. If you are growth minded come interview us and help us move to the next level. Future buy-in opportunity. Please leave a detailed message about yourself, your experience & desires @ (705) 789-6070.

MISSISSAUGA, SCARBOROUGH, BARRIE, BRANTFORD, ON Exciting associate positions available for full and part time opportunities. E-mail: yourdentaldream@gmail.com

NORTH OF SASKATOON, SK

FT, PT or Locum Dentist Needed North of Saskatoon First Nation Reserves. Travel Expenses covered. Long term commitment required. If interested please send resume to: northerndentalcentre@gmail.com

WWW.LAURIERDENTALCLINIC.CA 20 minutes east of Ottawa. Very busy recently expanded dental clinic seeking dentist for long term, full-time position. Multidisciplinary practice with the latest high tech equipment (2D & 3D x-ray). Mentoring available. Above average remuneration. Tel: (613) 446-3368 Fax: (613) 446-5006 laurierdental@videotron.ca

TORONTO, ON

Archer Dental is seeking a dynamic P/T associate with minimum 2 years clinical experience and a passion for geriatric dentistry. Excellent communication skills, energy and a flair for patient care! Experience in hospital dentistry an asset. Email in confidence to: narcher@drarcher.ca

EQUIPMENT WATERLOO, ON Dental Equipment For Sale 5 operatories of equipment including chair with accessories, intraoral xray units, custom built operatory cabinetry, instruments and Computer, as well as a Panoramic Xray Unit. Also Server, office computer, printer, fax, etc. Interested parties please contact me at wkamouni@hotmail.com

www.oralhealthgroup.com

14-11-10 11:12 AM

Sensodyne Repair & Protect ®

Sensodyne Repair & Protect is the first fluoride toothpaste to harness patented NovaMin calcium and phosphate technology to do more than treat the pain of dentin hypersensitivity. ®

• Repairs exposed dentin*: Builds a robust hydroxyapatite-like layer over exposed dentin and within dentin tubules. 1–5

• Protects patients from the pain of future sensitivity*: The hydroxyapatitelike layer is up to 50% harder than the underlying dentin and resistant to daily mechanical and chemical challenges. 6

1,6–8

* With twice-daily brushing.

Think beyond pain relief and recommend Sensodyne Repair & Protect

1. Burwell A, et al. J Clin Dent. 2010;21(Spec Iss):66–71. 2. LaTorre G, et al. J Clin Dent. 2010;21(3):72–76. 3. West NX, et al. J Clin Dent. 2011;22(Spec Iss):82–89. 4. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):62–67. 5. Efflant SE, et al. J Mater Sci Mater Med. 2002;26(6):557–565. 6. Parkinson C, et al. J Clin Dent. 2011;22 (Spec Iss):74–81. 7. Earl J, et al. J Clin Dent. 2011;22(Spec Iss):68–73. 8. Wang Z, et al. J Dent. 2010;38:400−410.

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COMPLÉTEZ LE TRAVAIL AVEC LISTERINE®. EN AJOUTANT L’ANTISEPTIQUE LISTERINE®, ON OBTIENT 2X PLUS DE SITES GINGIVAUX SAINS QU’AVEC LA BROSSE À DENTS ET LA SOIE DENTAIRE SEULES*1. *D’après le pourcentage moyen de sites gingivaux sains par sujet, après 6 mois. Analyse ultérieure de l’étude clinique de Sharma et coll. Étude clinique contrôlée d’une durée de 6 mois, à l’insu de l’observateur, en groupes parallèles, avec répartition aléatoire des sujets, menée conformément aux lignes directrices de l’American Dental Association; n = 237 sujets en bonne santé atteints de gingivite légère ou modérée pouvant être évaluée après 3 et 6 mois. Les sujets se sont rincé la bouche pendant 30 secondes deux fois par jour avec 20 ml du rince-bouche antiseptique LISTERINE® COOL MINTMC, à intervalles d’au moins 4 heures. 1. Sharma N, Charles CH, Lynch Mc, et coll. Adjunctive benefit of an essential oil-containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly: a six month study. Am J Dent Assoc. 2004;135(4):496-504. Pour les adultes et les enfants de 12 ans et plus.

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Le rince-bouche LISTERINE® ULTRACLEANMC antitartre contient : menthol à 0,042 % p/v, thymol à 0,063 % p/v, eucalyptol à 0,091 % p/v et chlorure de zinc 0,09 % p/v. Utiliser après s’être brossé les dents avec de la pâte dentifrice. Se rincer la bouche avec 20 ml non dilués pendant 30 secondes, deux fois par jour. Ne pas avaler. © Johnson & Johnson Inc. 2014

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VOS PATIENTS PEUVENT DORMIR AVEC

E S T R D O E S C S H E O T S U E O S T

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Vos patients peuvent trouver réconfortant de garder leur prothèse pendant la nuit, mais les conséquences peuvent être graves et englobent la mauvaise haleine, les infections fongiques et les caries plus nombreuses1-5. Guider vos patients à adopter de bonnes habitudes avant de se coucher pourrait être une des plus importantes conversations que vous aurez avec eux. Ces habitudes consistent dans le retrait de la prothèse et un nettoyage doux et antibactérien grâce à Polident®6.

* Fil Eur 3. E tulo End Can 9. O

1. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil. 1997;24(6):468–472. 2. Emami E, de Grandmont P, Rompré PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res. 2008;87(5):440–444. 3. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Endod. 2003;95(1):51–59. 4. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J J. 1979;147(10):267–272. 5. Compagnoni Ma, Souza RF, Marra J, et al al. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil. 2007;34(8):600–605. 6. Données internes de GSK, 2011.

/ ou sous licence GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4 MC

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MC/

Glax Mis

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BRISONS LE CYCLE état. Même lorsqu’ils dorment, plusieurs d’entre eux se sentent plus à l’aise avec leur prothèse. Ce sentiment peut nuire à la prise de bonnes décisions en matière de santé buccale. Au bout du compte, les patients peuvent négliger les rituels du soir essentiels pour la santé buccodentaire, à savoir, enlever leur prothèse le soir pour la laisser tremper dans une solution nettoyante pour les prothèses dentaires.

orsque vous traitez des patients portant une prothèse dentaire partielle, vous n’avez peut-être pas la possibilité de discuter des raisons et des circonstances qui les ont contraints à porter une prothèse. Vous n’avez peut-être pas le temps d’apprendre comment ils se sentent par rapport à leur prothèse ni pourquoi ils ne les entretiennent pas toujours convenablement. Pourtant, vous êtes en mesure de les aider à briser le cycle de la mauvaise hygiène dentaire. Lorsque l’humeur entre en conflit avec les soins dentaires Les patients qui portent une prothèse dentaire partielle se sentent souvent mal à l’aise. Ils hésitent à sourire et à rire : ils manquent de confiance en soi1. Leur prothèse leur donne un sentiment de sécurité et de « normalité ». Ils se sentent plus à l’aise lorsqu’ils portent leur prothèse. La situation se prolonge au-delà des moments passés en public : elle perdure jour et nuit. Les patients peuvent éprouver de la difficulté à se voir dans le miroir sans prothèse et encore plus de difficulté à laisser leurs proches les voir dans cet

Soins buccodentaires du soir La nuit, la bouche produit moins de salive. La salive joue un rôle clé dans la santé buccale, en aidant à protéger les dents contre la carie et à contrôler la présence des bactéries et des champignons dans la bouche2.

Malaise et honte

Problèmes de santé buccodentaire

Négligence de l’hygiène buccodentaire

Lorsque l’on garde la prothèse en bouche toute la nuit, elle peut accumuler des bactéries et des champignons qui peuvent, à leur tour, causer la mauvaise haleine, les infections fongiques et la carie dentaire 3-7. On devrait retirer la prothèse de la bouche pendant au moins trois heures; par contre, la retirer toute la nuit est idéal8. Les hygiénistes dentaires : acteurs incontournables de la santé buccodentaire En tant qu’hygiéniste dentaire, vous êtes en mesure de changer la vie de

4 4

D E LA M AU VA I S E H YG I È N E D E S P R OT H È S E S D E N TA I R E S

Diminution de la salive et du débit d’air

Augmentation des bactéries et des champignons

ces patients. Vous êtes cette voix réconfortante qui se fait entendre sur des sujets qu’ils ne veulent peut-être pas aborder. Vous êtes la personne qui peut conseiller ces patients sur l’importance d’avoir un rituel approprié le soir comprenant le trempage des prothèses dentaires partielles avec Polident®. La santé buccodentaire : un facteur de la qualité de la vie La santé buccodentaire est primordiale pour le mieux-être et l’état de santé global9. La formule de Polident® améliore la santé buccodentaire des utilisateurs de prothèse dentaire en pénétrant le ﬁlm biologique et en éliminant 99,9 % des bactéries causant les odeurs ainsi que les autres micro-organismes pouvant être à l’origine de problèmes buccaux*10,11. Contrairement au dentifrice, Polident® est non abrasif et ne crée pas de rayures qui pourraient favoriser la colonisation microbienne10. En plus de procurer une sensation de fraîcheur, une prothèse propre aide à réduire le risque d’irritation et de douleur des gencives11. Prendre le temps de recommander Polident® à vos clients peut faire toute la différence entre maintenir la qualité de la vie ou en perdre un peu plus.

Aidez vos patients utilisateurs de prothèse dentaire partielle à briser le cycle de la mauvaise hygiène dentaire avec Polident®. Aidez-les à conserver leur qualité de vie. * Film biologique d’une espèce unique de plaque in vitro après trempage de 5 minutes. Références : 1. Trulsson U, et al. Edentulousness and oral rehabilitation: experiences from the patients’ perspective. Eur J Oral Sci. 2002 Déc;110(6):417-24. 2. National Institute of Dental and Craniofacial Research. Dry Mouth. http://www.nidcr.nih.gov/oralhealth/Topics/DryMouth/Documents/DryMouth.pdf. Consulté le 25 juillet 2014. 3. Emami E, de Grandmont P, Rompre PH, et al. Favoring trauma as an etiological factor in denture stomatitis. J Dent Res 2008;87(5):440-444. 4. Jeganathan S, Payne JA, Thean HP. Denture stomatitis in an elderly edentulous Asian population. J Oral Rehabil 1997;24(6): 468-472. 5. Barbeau J, Seguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95(1):51-59. 6. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J. 1979;147(10):267-272. 7. Compagnoni MA, Souza RF, Marra J, Pero AC, Barbosa DB. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil 2007;34(8):600-605. 8. Halton Region. Denture Care. www.halton.ca/common/pages/UserFile.aspx?fileId=100069. Consulté le 19 août 2014. 9. Organisation mondiale de la Santé. Oral Health. http://www.who.int/oral_health/objectives/en/. Consulté le 25 juillet 2014. 10. Données internes de GSK, Lux R. 2012. 11. Données internes de GSK, CSS MFC51013, 2014. MC/®

ou sous licence GlaxoSmithKline Soins de santé aux consommateurs Inc. Mississauga, Ontario L5N 6L4

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Sensodyne Répare et Protège ®

Activé par NovaMin

Sensodyne Répare et Protège est le premier dentifrice au fluorure à exploiter la technologie du calcium et du phosphate NovaMin brevetée pour faire plus que traiter la douleur liée à l’hypersensibilité dentinaire. ®

• Répare la dentine exposée* : Crée une solide couche semblable à l’hydroxylapatite sur la dentine exposée et dans les tubules dentinaires . 1–5

• Protège les patients de la douleur liée à la sensibilité future* : La couche semblable à l’hydroxylapatite est jusqu’à 50 % plus dure que la dentine sous-jacente et elle résiste aux attaques mécaniques et chimiques quotidiennes . 6

1,6–8

* Avec un brossage deux fois par jour.

Pensez au-delà du soulagement de la douleur et recommandez Sensodyne Répare et Protège.

1. Burwell A, et al. J Clin Dent. 2010;21 (numéro spécial):66-71. 2. LaTorre G, et al. J Clin Dent. 2010;21(3):72–76. 3. West NX, et al. J Clin Dent. 2011;22 (numéro spécial):82-89. 4. Earl J, et al. J Clin Dent. 2011;22 (numéro spécial):62-67. 5. Efflant SE, et al. J Mater Sci Mater Med. 2002;26(6):557–565. 6. Parkinson C, et al. J Clin Dent. 2011;22 (numéro spécial):74-81. 7. Earl J, et al. J Clin Dent. 2011;22 (numéro spécial):68-73. 8. Wang Z, et al. J Dent. 2010;38:400−410.

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