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    How to get your patients to ramp up their oral hygiene efforts

    Being creative and using metaphors can make educating your patients a fun process.

    I’ve been a refrigerator hygienist for many years. This nickname was given to nurses years ago and refers to nurses who go to work simply to pay for a specific item or a vacation. They work to provide for their families, and if the family doesn’t need the extra cash, then they stay home. Refrigerator nursing is now considered demeaning in health care circles and instead refers to part-time employment.

    However, refrigerator hygiene (part-time employment) has been good to me and my immediate family. It’s provided me adequate time to write, which is an ongoing passion, and it’s given my life the much needed balance I’ve come to appreciate.

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    For me, one of the disadvantages of working part-time has been the lack of participation in the selection of self-care items that are dispensed to patients in “goody” bags, but I’ve noticed a trend toward “less is more” in a lot of dental practices, especially in PPO practices with discounted fees. Most patients don’t use the floss sample since less than a quarter of patients floss and the evidence to date to support dental flossing to reduce plaque at one and three months (from 10 studies) is weak.1 No studies report the effectiveness of flossing plus toothbrushing as a dental caries-preventive measure. Experience in the tooth and gum trenches has taught me to focus not on the flossing message but on encouraging changes in diet and oral hygiene and explaining their effect on oral health and biofilm. As most dental professionals already know, biofilm composition changes with poor oral hygiene, lifestyle and diet.2

    Freaky facts about biofilm

    In addition to being a refrigerator hygienist, I’ve labeled myself a biofilm freakazoid! Since 2002, when I read the first publication on biofilm titled “Emerging Trends in Oral Care: The Biofilm Revolution” by Scientific American, Inc. and Philips Electronics, I have been mesmerized by the topic and have poured over every magazine article and book I could find.

    I do whatever I can to engage my adult patients, especially boomers who need to ramp up their oral hygiene efforts. Most boomers I encounter have exposed roots and these surfaces, along with the cemento-enamel junction (CEJ), are biofilm magnets. Along the way, I’ve discovered a way to attract the attention of millennials, too. Here’s a sampling of a customized script that I’ve used before:

    Bacteria either live within a sticky slime or carry a bit of it around them like Spider-Man’s cape! With this protection, they can move around from place to place like Spider-Man. Think of them as cobwebs or silky strands, and while you’re here with me over the next hour, I’ll scrape and polish them off your teeth. Just as a spider uses its web to catch prey or make cocoons for their eggs, bacteria don’t survive without biofilm. Just as you would take a broom and disrupt a cobweb on the ceiling of your house, you need to thoroughly disrupt all the biofilm around your teeth, including the exposed roots. Biofilm likes to live where it’s moist and the gumline is the best building lot in the neighborhood.  Toothbrushing, when done properly, will easily remove biofilm, but there’s a big space called an embrasure that houses a lot of it. For these areas, as with toothbrushing, I will customize what works best to eliminate those silky strands.

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