We know today that oral health and systemic health are interrelated and the importance of a dental hygiene appointment is now more than “just a cleaning.” The various assessments completed during a dental hygiene appointment can be lifesaving.

Take a look at the “to do” list during a dental hygiene appointment. If you had to prioritize this list what would you put at the top of your list? Once you select your #1 service, break down your dental hygiene appointment into sections: the beginning of the appointment (exam and assessments), the middle of the appointment (scale & polish), and the end of the appointment (the doctor exam and scheduling the next hygiene apt.). What service in the dental hygiene process of care do you dedicate the most time to? Is it the beginning, middle, or end? Are you dedicating the most amount of time to the service you identified earlier as the most important? Do you find that you are spending more than 20 minutes during the mid-point (Scaling and polishing) of the dental hygiene appointment? If you say “Yes”, then you are most likely providing something that is “More than a Prophylaxis.” If your mid-point is greater than 20 minutes in length you need to re-think what the diagnosis or periodontal type of this patient truly is.

Patient assessments, especially the review of the health history, blood pressure, periodontal screening exam, and the oral cancer exam are the most important services you will provide during a dental hygiene appointment.

As a dental hygiene coach/consultant, I typically find that a large majority of dental hygienists say they “don’t have time to do these screenings”. I have also discovered that many hygienists don’t understand the importance of the oral cancer screening because they have never actually found a suspicious lesion. To that I say “Are you going to WAIT until the 1^st time a patient has a melanoma or suspicious area to begin examining for oral cancer?” Many hygienists focus on scaling and polishing the teeth. After all, most of the patients expect to leave the dental hygiene appointment with clean teeth!

Many clinicians will classify the appointment a “success” when they are able to scale and polish perfectly, every tooth in the arch, while eliminating extremely important screenings in order to do this.

Do you provide blood pressure screenings at least once a year as a courtesy to your patients at every visit? This is a great value add service to your patients and will go a long way creating a “win” for everyone!

Regarding the oral cancer exam, the death rates associated with oral cancer are not attributed to issues with diagnosis. The death rates are directly related to late diagnosis. Epidemiologists state that until we have standardized, comprehensive programs to screen for oral cancer, patients will continue to get diagnosed far too late in the disease progression; the late stage discovery where the disease is already metastasized is extremely common. Between 1988 and 2004, the incidence of-positive oropharyngeal cancers increased 225%.(1)

When you have less than 60 minutes for a prophylaxis or supportive periodontal maintenance appointment it becomes almost impossible to complete the very important screening exams which can be a life-saving tool!

Remember the motto for the twenty-first century “The Dental Hygiene Appointment is about Providing Total Health!”

References

1. J. Clin. Oncol. Chaturvedi, A. et al 2008; Incidence Trends for Human Papillomavirus Related and Unrelated Oral Squamous Cell Carcinomas in the United States. 26:612-9.