Finding your Passion in Prevention and Oral Medicine. Image: © luismolinero - stock.adobe.com
Most of my dental hygiene colleagues are busier than ever at work but many report to me that they are no longer appreciated for their role as an educator. This trend is such a shame because most of us are really good at educating patients, and it is a part of our identity. When I’m working a temp day, my favorite moments come when I can make a difference in someone’s life and yesterday I was reminded of why it is important.
I worship on Sundays in a small country church called Hopewell. The congregation is small but mighty and the Pastor has a good understanding of the Bible. Yesterday, he talked at length about a book of the Bible that I’m not too familiar with. Ecclesiastes is a very old book written in about 930 BC. In it, King Solomon (an older, wise man) writes about life’s meaning and he includes all things in life that we value: having a career, wealth, pleasures, etc. and he calls them smoke and tells us that these things do not last. In dentistry, we may build great, beautiful practices and we may indulge ourselves in Caribbean cruises or designer homes, but Solomon tells us that a pretentious, showy life is an empty life. We’re all capable of being more than a hamster on a wheel who stays busy in meaningless tasks. One of the joys of dental hygiene practice that gives dental hygiene practice meaning is connecting with people and helping them make significant changes that impact their overall health and wellbeing.
My boyfriend, Greg recently visited a well-known dental service organization (DSO)-practice as a new patient after his last visit to a group practice (the month before) was a total disaster. The DSO-practice insisted on taking their own radiographs so they took another FMX and Panorex. Their NP exam was a bit better than the last one and a periodontal exam was performed this time around. At the group dental practice, neither an oral cancer or periodontal exam was performed and I was there as a witness. I didn’t go with him to the DSO-practice appointment but he’s well aware of the 323/323 drill and let me know that they performed the periodontal exam to his satisfaction. What changed this time after the initial exam was the estimate for restorative and periodontal treatment. The total treatment plan this time around was double what it was in the group practice. Being a nosey parker, I wanted to see the estimate for the periodontal component and I wasn’t surprised to see professional irrigation and placement of Arestin included. There was also a code included for oral hygiene instruction but no charge included for the educational session(s). I was glad to see oral hygiene instruction added to the treatment plan but wondered what exactly would be included.
In the end, Greg went to my personal periodontist for an exam and was treatment planned for SRP without Arestin or professional oral irrigation. Most of the 5 mm probing depths were around his third molars which have lost a lot of alveolar bone and are treatment planned for extraction. He didn’t need the education component because I’ve completely changed his daily routine and educated him about oral hygiene and disease prevention from the first day we met!
Finding Your Niche in Disease Prevention
Finding an area of prevention to be passionate about is important and may provide more meaning to the daily grind, especially if you tailor your recommendations to each individual based on their needs. Maybe you’re passionate about substance abuse, diabetes prevention and management, biofilm management, or CAMBRA. Pick an area of prevention or oral medicine and dive into it.
How do we create an area of passion when all day long we’re struggling to get a potty break or eat lunch?
Figure out what you do during the day that puts a smile on your face.For me, I love to talk to the patient while I’m working. I don’t enjoy random gossip or political conversations and I’m happiest when I hone in on a problem that the patient needs help with. How do you figure out what area of prevention interests you most? I’ve been fascinated lately with Anne Guignon’s Out of the Box Learning Academy. Like me, she’s been a dental hygiene columnist for many years and she has many topics she’s passionate about. Her courses are affordable, evidence-based and there are a variety of topics to choose from. One of my favorite topics is covered by Anne in her course and it is called Saliva Chronicles. Saliva plays a critical role in oral health and the integrity of tooth structure. Salivary components reduce tooth surface exposure to demineralization, protect teeth against wear, and aid in enamel remineralization.
Early in the website development phase is a diabetes educational and advocacy website for dental professionals and patients. The website is being developed by Frank Varon, DDS. Dr Varon has dedicated many years of study to the role of the dental professional in diabetes care. The new website, which should be fully functional this September (2023) is needed due to the ongoing complexity of managing diabetes patients in dental practice. Dr Varon’s father was an endocrinologist whose knowledge and dedication to the specialty rubbed off on him. Dr Varon realized there was a large disparity in diabetes care knowledge between the medical and dental professions. Having felt a call to action to bridge that gap, Dr Varon dedicated himself to that cause.
I asked Nancy Burkhart EdD, MEd, BSDH, AAFAAOM to share her commitment and passion for Oral medicine including her interest and leadership in educating dental professionals about oral lichen planus. Dr Burkhart was my student when I taught at Fairleigh Dickinson University, School of Dentistry and I knew then she was destined for lifelong commitment to a cause.
Nancy Burkhart EdD, MEd, BSDH, AAFAAOM: The practice of oral medicine has been in existence for many years with the American Academy of Oral Medicine (AAOM) being founded in 1945. It now recognizes those who select to become board certified in the practice of oral medicine. The AAOM is responsible for examining those eligible for diplomate specialist status–they must have completed a CODA accredited oral medicine residency program in the United States. The exam is given once a year at the annual meeting. Along with the Board Certification exam, those eligible to challenge the Academic Fellowship exam and the Affiliate Academic Exam are given the opportunity as well. Requirements include attending 2 meetings–one of which may be the meeting in which the exam is given. They must be a member of the AAOM and meet the requirements needed to take the exams. Those who take the Affiliate Academic exam are in non-DDS/DMD areas such as: physicians, veterinarians, dental hygienists, nurses/nurse practitioners, pharmacists, researchers in many disciplines, and those who practice in an oral medicine center.
The AAOM is a most welcoming group and I have been a member since 1997. At one time, you needed to be sponsored by a diplomate of the organization and my sponsor was the late Terry Rees, DDS, MSD. Since I was a faculty member in the oral medicine center at Texas A&M, the connection was a great way to participate and learn the concept of oral medicine. Because of my interests and my evolving knowledge of mucosal diseases and treatment, the International Oral Lichen Planus Support Group evolved. At that time, the internet was certainly not what it is today, and when we conducted our first session, we were not even on camera, and we typed and answered questions for the entire hour of the session. Looking back, it was very primitive.
The support group has grown, and we have sponsored many webinars with those who have knowledge in the treatment of oral lichen planus since 1998 with many patients and professionals who participate from all over the world.
How did I end up in a oral medicine center at Texas A&M? As I conducted my doctoral degree at North Carolina State University in Education, I wanted to bring in the “dental component” to the degree with a pathology focus. I arranged to take the doctoral level pathology courses at The University of North Carolina, Chapel Hill. I was also a faculty member in the department of dental ecology at the time as well. In addition to the courses, I conducted a one-year post-doctoral fellowship in the oral pathology department. During the fellowship, I taught, processed tissue samples daily, attended biopsy read outs daily and learned a lot. The fellowship ended with my dissertation on oral lichen planus, several papers published in dental journals, teaching oral pathology to the dental hygiene students and an exam at the microscope! After my fellowship ended, I was extended for another year in the pathology department to continue my work. Dr Rees was speaking at the dental school, and when I met with him there was an instant connection. He asked me to apply for a position in the oral medicine center/dental hygiene and months later, I was in Texas! It is interesting where life takes you!
I encourage anyone to attend an annual meeting with the AAOM, join as a member and there will be someone who has the same interest in a disease state that you have an interest in, patient treatment or a subject you are interested in as well. There is something for everyone! The group is welcoming, and I chair the Academic Affiliate Academic Fellowship for the academy. See you there!
Find Topics to be Passionate About that Align with your Values
Having lost a daughter about 2 years ago, grief snuck up on me like a surprise undertow for an ocean bather and I rolled around in it for about a year and a half. Most of the time, I sat around the house in a recliner and ate for comfort. As a result, even though I was exercising, I started to feel unhealthy and my blood pressure rose to an unacceptable level. Instead of continuing to feed my emotional numbness, I published a children’s book called Tales of Teddy Tooth and ended up losing 40 pounds while learning as much as I can about optimum health. In dental hygiene, I’m still full of passion for periodontal therapy and evidence-based dentistry but it’s always fun to develop new interests.
Figure out what you can talk about or do for hours on end that lights you up. Right now, the U.S. and the rest of the world seem wobbly and there are times when finding meaning day to day is a challenge.
When I find myself feeling negative and starting to wallow in my own misery, I break free and challenge myself to find my purpose. Dental hygiene can be monotonous unless you use your skills, experience and values to ignite a passion. If Frank, Nancy and I can do it, you can do it, too.
Oral medicine recently became the 11th dental specialty, joining the other 10 dental specialty areas recognized by the ADA.
Oral Medicine is defined by the American Academy of Oral Medicine as the discipline of dentistry concerned with the oral health care of medically complex patients – including the diagnosis and management of medical conditions that affect the oral and maxillofacial region.
Oral medicine is primarily a non-surgical specialty with procedures limited to diagnostic biopsies, small excisions, therapeutic injections, and other minor surgical interventions. In many cases, conditions are managed medically with the use of topical and systemic medications.
Our specialists are experts in the diagnosis and management of patients with:
- Oral mucosal and salivary gland diseases
- Oral complications resulting from systemic disease
- Oral complications from cancer treatment
- Chemosensory and neurologic impairment of the oral and maxillofacial complex
- Orofacial pain including temporomandibular disorders