Q: I was visiting my family in California, and they were raving about their hygienist. Since I was due for a cleaning, I decided to get a cleaning before returning to Florida. I was blown away and realized that my home town hygienist was way out of date in comparison. Can you address when one should consider changing hygienists?
A: I am often in this predicament when it comes to hairstylists and mechanics. I feel sometimes I get enamored by the personality of the vendor, which can blind me from realizing that I am not getting the best service. The opposite also holds true. I have had mechanics and hairstylists with the personality of a wet noodle, but produce great products or services. (I had a doctor in NY years ago who was so void of personality, the only proof he was alive was an occasional burp during the conversation.)
As the old Donald Rumsfeld used to say in regards to what we knew and didn’t know about Iraq: “We don’t know what we don’t know.” (Obviously we “know” he was a Yogi Berra fan.)
The Hi-Tech hygienist uses:
Fluoride Varnish: At the end of your cleaning, to prevent decay and sensitivity to cold, he or she must apply a fluoride varnish. This white sticky coating can re-mineralize demineralized teeth by forming fluorapatite, which is more acid-resistant. It also interferes with decay, causing bacteria and reduces sensitivity. This needs to be used in children AND adults.
Annual Periodontal Charting with Pocket Measurements: The keyword is “annual.” This measures the loss of bone and ligaments that hold your teeth into your jaw bone. Pockets that are five millimeters or greater cannot be cleaned out by your floss or brush or even a routine cleaning. These need periodontal treatment, such as SRPC; scaling, root planing, and curettage; a non-surgical gum treatment.
Arestin: Antibiotic granules that are locally placed into the pockets to kill bone and flesh-eating bacteria.
Medicinal Irrigation: A small, hollow blunt cannula that washes out the pockets with chlorhexidine; an anti-bacterial medicament that kills periodontal microbes.
Digital X-rays: Make sure every three years, a full set of 18 separate images are taken. (Not the one that rotates around your head called the panorex or panoramic. This is mainly for wisdom teeth, orthodontics, and trauma to the jaws.) And make sure that a set of four “bite-wing” X-rays are taken. These show the back molar teeth only, but as long as the full set is up to date, this allows us to view decay and bone loss around the back molars.
Teflon or Titanium Scalers: This will not scratch your implants. Scratched implants will attract more plaque and could lead to failure from bone loss.
Personality aside, these are just a few points to look for when evaluating a hygienist for your preventive care.