5 surprising things your patients don’t know about their dental visit

May 1, 2017

Reminding your patients how much they truly benefit from a visit is important.

A lot happens at your patients’ preventive appointments, but because you see patients day in and day out, you may forget to remind them about the remarkable things happening when they come in to see you. In fact, the basics you provide patients at each visit may be lost on them. Why is fluoride a big deal? What’s being scraped off their teeth and why is that important?

Preventive care really does prevent a lot of problems. Remind your patients what’s happening at their preventive appointment and you might be surprised by how much they respond.

Here are five things to share with patients that might seem basic, but may just surprise them-and might also inspire them to thank you.

Remind patients: They can scrub their gums away by brushing too hard.

One thing that’s always surprising to patients is that brushing too hard can actually cause more damage than periodontal disease or cavities, says Sarah Thiel, RDH, CEO of CE Zoom, and a clinical practitioner in Farmington, New Mexico. Thiel says reminding patients that they can brush their gums off by brushing too hard works wonders, and she often shows them their X-rays so that they can see what’s happening with the bone that’s holding their teeth in place. That’s also Thiel’s reasoning for recommending an electric toothbrush, because it has a pressure protection sensor that lets you know you’re brushing too hard.

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“I see brushing too hard all the time,” Thiel says. “I would bet that 70 percent of my patients have recession of some sort, and it’s accompanied by sensitivity, so they can’t eat ice cream or when they do, it hurts.”

Most of the time recession and sensitivity is from the mechanical action of scrubbing their gums too hard, she says. It can also be from using a hard bristled toothbrush.

If patients are going to use a manual toothbrush, a good trick to remind them is to only hold the brush with their thumb, index and middle finger instead of their fist, because that way they can’t push as hard.

“Plus, it makes you focus; people will get in [auto] pilot mode anyway when they brush, but at least if you are just holding the toothbrush with three fingers you can’t push as hard,” Thiel notes, suggesting you also, of course, can still remind them to only use a soft toothbrush.

Remind patients: Their mouth is connected to their body.

This might seem obvious, but most patients don’t make the connection that their mouth is connected to the rest of their body.

“If you have an infection in your mouth, it’s going through your whole blood stream and it can cause diabetes, heart disease and stroke,” Thiel says, noting that gum disease can lead to even bigger health problems. Research shows that diabetes and periodontal disease, for instance, have a direct link-something of which most patients are unaware.

Thiel reminds her patients it’s all connected, so if they have diabetes or heart disease they should pay special attention to their mouth, and vice versa. Patients with infection and gum disease should not only get it under control with their dental professional but also see their doctor regularly about the rest of their health.

“Oral health and the health of your body aren’t separate things anymore,” Thiel says. “Everything is connected.”  

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Remind patients: An electric toothbrush cleans better than a manual.

Ethel Hagan, RDH, a dental writer and clinical practitioner in Charlotte, North Carolina, thinks making a case for electric toothbrushes is important.

“My patients use about 50/50 electric versus manual, but I always give them my spiel about the electric toothbrush,” she explains.

One such brush, for instance, rotates about 30,000 strokes per minute, says Hagan, while a manual toothbrush clocks about 200 strokes per minute. Plus, electric toothbrushes have timers to let patients know when their two minutes of brushing are up by automatically shutting off.

“I think the electric ones clean better because of the number of strokes,” Hagan says. She tells her patients she can typically spot patients who brush with an electric model from those using a manual because “there’s less stain, less bleeding and less gingivitis,” which intrigues them.

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What’s more, a lot of patients don’t realize they have stains or areas they miss with a manual, so Hagan likes to point those spots out. She also recommends an electric toothbrush for people who drink red wine, cola or coffee since electric brushes may do a better job of removing stains.

Remind patients: They need to see the dentist regularly.

Most patients know they’re supposed to get regular dental checks, but they may not be sure why. Remind them that even if they are stellar brushers and flossers, effective brushing and flossing really only gets about 3 mm below the gum line, says Tina Clark, RDH, BSDH, MED, a clinical hygienist and dental hygiene teacher at Oregon Technical School.

“In order to get anything deeper than that, you have to see your oral health care provider,” Clark says.

In addition, remind patients there just aren’t any in-home oral health aids that can clean that far below the gumline. They need their hygienist to do it. Clark explains that the plaque that sticks below the gumline is what causes cavities and gum disease if allowed to remain, so removing it with regular dental visits is key.

Reiterate that patients should follow their oral health care provider’s advice on how often they should be seen.
“Some need to come in every month, and some can go two years,” she says.

It depends on how well they brush and floss, their genetic make-up, the medications they take and their health conditions, like diabetes, which can complicate their dental health. Once they understand why they need to come regularly, and how often is recommended in their case, they usually do a great job of fitting in professional oral health care.

Remind patients: You’re talking about their oral health.

One thing that’s important in Thiel’s office is the handoff between the doctor and hygienist. When the dentist comes into the exam room, the hygienist typically updates him or her on the patient’s health-that their oral cancer exam is negative or that there’s a questionable spot on the distal of number 30.

“Suddenly the patient clues in and listens to everything we are talking about,” Thiel says.

It’s like a lightbulb going off for the patient that says “this is my oral health.” Thiel says patients then realize she examined their gums, looked for oral cancer, checked their X-rays and performed a lot of important evaluations besides just cleaning their teeth. Next, the dentist steps in to examine them further.

“The handoff is the perfect time to fill them in on all of the findings and explain any problems,” Thiel says.