JOANNA CAREW

A friend of mine in Norfolk had such an unpleasant experience with a hygienist she was left weeping and despondent about her oral health. To maintain anonymity I’ll call her Sarah.

The problem is I’ve heard so many similar tales, and it makes me mad as I feel it contributes to the pervasive fear Brits hold about visits to the dentist, and undermines the fabulous hygienists we have working up and down the country.

Sarah is middle class, educated, and cares about her wellbeing. She brushes twice daily and has always used NHS dentistry, having dental health checks albeit hygiene appointments weren’t offered. In recent years Sarah hasn’t been able to see an NHS dentist due to lack of availability and so let routine visits slip. Then Sarah had a problem, losing a filling, and needed to be seen quickly.

As a private practice we see this scenario daily and, like thousands of others in need, Sarah ended up having the filling replaced privately (not at Carew Dental).

During the appointment the dentist informed Sarah she has gingivitis and needed to see their hygienist for a deep clean under local anaesthetic – again this is so common for patients that haven’t been keeping up with routine appointments. A situation that is compounded by not having seen a hygienist previously, as oral health education has never been provided.

Sarah duly attended her hygiene appointment and described it as akin to being a schoolgirl dragged in front of the headmistress. She said she felt ridiculed and belittled for not having maintained her oral health, for not cleaning interdentally, and for stopping using her electric toothbrush due to painful gums.

Sarah reported the hygienist appearing annoyed and saying was there any point in her even carrying out the treatment if Sarah wasn’t able to maintain her home hygiene properly. Then proceeding to carry on with the treatment anyhow.

During the appointment Sarah was told how to brush and not to use mouthwash as it washes fluoride away. Then she was given a heap of different coloured tepees and told to work out which ones fit which spaces, then to buy whatever she needs.

Sarah returned home feeling wretched and thick, as well as despondent about the new home routine she had to try and figure out. She’s reported it taking 20 minutes every sitting as she’s not managing the tepees very well and finds herself getting the angles wrong and stabbing her gums more than cleaning between the teeth.

In fairness, I haven’t spoken to the hygienist and don’t know them. Plus, aside from the reported mouthwash advice, I felt that much of what was advised is sensible, however, the communication style sounds horrific.

Sarah is warm and articulate, and not a fool. She’s simply never had any oral health education. Actually, she was a great candidate for improving her oral health as she was engaged and cares about her wellbeing. Instead, she came away disengaged and despondent.

At Carew Dental our hygienists work with many patients like Sarah, and our appointments focus on education and empowerment. These patients are learning new skills and good on them! We take time to find the right oral aids and to build sustainable routines for patients to follow. A standard part of the protocol is for the nurse to use the patient’s phone to film them in-surgery so they can replicate the routine at home, watching back and knowing exactly what to do and which aids to use etc.

For Sarah, I ended up providing her with various types of interdental aids so she could try different options and find one that suits her. We chatted through that she wasn’t stupid, she’d just never been taught, and that she’ll get there. Plus I offered her a free Zoom appointment with our hygienist to talk through her concerns.

I felt obliged to restore Sarah’s confidence and feel ashamed that someone in our profession has caused so much upset.

Actually this story made me MAD!!!!!! If it is a true account of what happened, it’s just not good enough. Please don’t belittle someone then give them a home routine that’ll take 20 minutes a time. Even the most engaged patient will feel disengaged and give up. Then they’ll end up in an even worse situation than they started with!!!

As far as my experience goes, the average patient understands they should brush twice daily for 2 minutes at a time. But they often come to us with little to no understanding about the angle of the brush, flossing and other interdental cleaning, mouthwash, etc etc. Nor the importance of regular hygiene appointments.

My mission is education, education, education. It’s never too late to learn about oral health and kudos to anybody who is willing to give it a go!

Hygienists are pure gold, our educators, and the linchpin to achieving good oral health.

Grrrrrrrrr to the bad apples, and THANK YOU to the thousands of outstanding professionals caring for our oral wellbeing 💛🩶