Polishing-When and why

  It has been brought to my attention by a couple of hygienists that they polish before they start the cleaning!  Any patient with plaque will be polished before the gross scaling starts because it's gross to push plaque around and you need visibility. I finish the cleaning with a polish also for all the reasons we polish at the end of the cleaning.

Gag reflex and Dental X-rays

  People who gag while getting dental x-rays have a phobia about putting things in their mouth.  The gag reflex is a panic attack.  The tongue is like a bouncer at the bar door and will cause the gag reflex.  If you have a skiddish bouncer he will puff his chest out, ask no questions and block any suspect from entering through  the bar door!
  Phobias are unreasonable fears coming from the primitive(or reptilian) part of our brain. That's the fight or flight response...no reasoning just knee jerk reflex.
   I tell the patient they have a phobia or fear of things in their mouth...which comes from the primitive part of their brain ...and I touch the back of their head.  Then I put my hand on their forehead and tell them that's their pre-frontal cortex or human reasoning part of the brain.  The pre-frontal cortex can talk to the primitive part of the brain....tell it to relax and buy some time.  I show them with my finger where I will put the x-ray sensor(no surprises)...tell them I will go around the corner...punch a button ..they will hear a buzz..then they can do what ever they need to do with the sensor.
   I take full mouth x-rays every day and have no problems with my phobic patients.

Oral Hygiene for an Aging Population

 Now that the aging population are going into assisted living with their teeth, not dentures. I'm seeing adult children bring their parent into the office.  What you see is a person who took good care of their mouth all their life and now there is nothing happening...no brushing, flossing or tooth picking. The layman is intimidated with the idea of being in some one's mouth. There is a niche to be filled and a hygienist/dental assistant could make money and fill a need.  Example: I would enter into a contract with the adult child...for a fee I would,once a week,  brush the parent's teeth and gumline, use a end tuft brush between the teeth coming from the buccal and lingual, using mild flouride mouth wash instead of tooth paste which is messy, and finish with the parent rinsing with the mouthwash. I would communicate any complaints the parent had with the adult child about their mouth. I would put the brushes in a sterilizing pack with the parent's name to sterilize and reuse. It takes about two weeks after cleaning the mouth for the biofilm to reestablish its self. What if you had 15 patients at one rest home that you charged $40/mo. to brush their teeth once a week.....that's $600/ month for a half days work........just an IDEA if I ever retire from my day job!

How to Soften Calculus

   If you are working with old tenacious calculus...don't try to take it off in one appointment.  It builds in layers..think of an onion. The outer layer is the softest and the innermost layer is the most tenacious.  I get as much off as I can with a sonic cleaner. Basically I do a gross debridment throughout the mouth. Then I reschedule the patient in two or more weeks.  The outer layer of calculus will soften in those two weeks.  I repeat the process...most of the time three appointments will do it...one time it took me five appointments on a lady in her fifties who had never had a cleaning.  Refer to my blog "Calculus and it's Characteristics" and "First Time I See the Patient"

Please read this blog in chronological order starting at the bottom and working up....the blog directly below this is the least important blog to me..an after thought!